心脏超声、核磁共振和心血管造影技术在婴儿左向右分流先天性心脏病诊断中的应用价值

The applied value of echocardiogram,magnetic resonance imgaging and angiocardiogram for the diagnosis of infant congenital heart diasease with left to right shunt

目的 :探讨心脏超声、核磁共振 (MRI)和心血管造影在婴儿左向右分流先天性心脏病 (先心病 )诊断中的应用价值。方法 :88例年龄小于 1岁的婴儿均行心脏超声及MRI检查 ,并作增强磁共振血管造影(CE MRA) ;88例中 12例作心血管造影检查 ,其中 4例合并主动脉缩窄 (COA)者同时作经皮球囊COA成形术。结果 :心脏超声显示单纯室间隔缺损 (VSD) 6 6例 ,单纯房间隔缺损 (ASD) 2例 ,单纯动脉导管未闭 (PDA) 3例 ,VSD合并ASD 11例 ,VSD合并PDA 2例 ,ASD合并PDA 1例 ,VSD合并ASD、PDA 3例。MRI检查出超声心动图漏诊伴有主动脉弓病变 18例 (占 2 0 .5 % )。 12例心血管造影均有不同程度的主动脉缩窄 ,且介入治疗者获得成功。结论 :超声心动图能对左向右分流先心病心内结构异常作出准确诊断 ,而MRI可排除心外大血管畸形 ;心血管造影则在超声心动图和MRI不能提供准确主动脉弓病变或需介入治疗时应用。

Objective:To evaluate the applied value of echocardiogram,magnetic resonance imgaging and angiocardiogram for the diagnosis of infant congenital heart diasease with left to right shunt.Methods:88 cases were underwent ECHO and MRI,especially contrast-enhanced 3D MRA. 12 of 88 cases were underwent angiocardiogram,and 4 cases associated with coarctation of aorta (COA) were performed balloon dilation simultaneously.Results:In 88 cases diagnosed with ECHO,66 cases were indicated VSD,2 ASD,3 PDA. 11 VSD associated with ASD,2 VSD associated with PDA,3 VSD associated with ASD and PDA,1 ASD associated with PDA. MRI showed 18 cases with the anomaly of aortic arch,which the echo did not diagnosed. 12 cases were demonstrated associated with COA in angiocardiogram,of whom 4 cases had a good outcome by balloon dilation.Conclusion:The echocardiogram can exactly diagnose the intracardiac anomaly with left to right shunt. The MRI can excludes the anomaly of great vessels out of the heart. The patients need not be undergone angiocardiogram and can be operated directly unless the hemodynamic data is not clear by Echo or MRI and the patient is need to be undergone the interventional therapy.