小儿先天性肺动脉吊带及左肺动脉缺如的超声心动图诊断价值

Diagnostic value of echocardiography for congenital pulmonary artery sling and left pulmonary artery deficiency in children

目的:探讨经胸超声心动图(TTE)在小儿先天性肺动脉吊带及左肺动脉缺如诊断中的价值。方法:以CTA和手术证实的21例肺动脉吊带及左肺动脉缺如患儿为研究对象,回顾分析其超声心动图特征。结果:21例中,经CTA或手术证实肺动脉吊带15例,左肺动脉缺如6例,TTE诊断17例,漏诊3例,误诊1例,诊断准确率81%,1例肺动脉吊带合并房间隔缺损(ASD)漏诊,1例单纯肺动脉吊带漏诊,1例左肺动脉缺如合并法洛四联症(TOF)漏诊,1例将左肺动脉缺如误诊为肺动脉吊带。结论:TTE是早期诊断肺动脉吊带及左肺动脉缺如的重要手段,应多切面扫查,减少漏诊误诊。

Objective: To explore the diagnostic value of transthoracic echocardiography(TTE) for the deficiency of congenital pulmonary artery sling and left pulmonary artery in children. Methods: The clinical manifestations and echocardiographic features were analyzed in 21 cases of pulmonary artery sling and left pulmonary artery deficiency confirmed by CTA and surgical findings. Results: In 21 cases, 15 cases with pulmonary artery sling and 6 cases with left pulmonary artery deficiency were confirmed by CTA or surgery. Among the 21 cases, 17 cases were diagnosed by TTE, 3 cases were missed and 1 case was misdiagnosed. The diagnostic accuracy rate was 81%, 1 case of pulmonary artery sling with atrial septal defect(ASD) was missed, 1 simple pulmonary artery sling was missed, 1 case of left pulmonary artery deficiency with tetralogy of fallot(TOF) was missed and 1 case of left pulmonary artery deficiency was misdiagnosed as pulmonary artery sling. Conclusions: TTE is an important means for the early diagnosis of pulmonary artery sling and left pulmonary artery deficiency. We should scan multiple aspects thus to reduce the missed and misdiagnosed cases.