完全性肺静脉畸形引流的超声心动图诊断

目的：评价超声心动图对完全性肺静脉畸形引流（TAPVC）的诊断价值。方法：回顾分析16例超声诊断为TAPVC的超声心图特征，其中11例超声结果与手术结果相对照，超声检查内容包括二维及彩色多普勒显像，分别经胸骨旁、胸骨上窝，剑突下等部位多切面观详细观察肺静开口部位，引流途径，共同肺静脉干形态及存在的合并畸形等。结果：按Darling等的分型，16例TAPVC患者中超声诊断分型为：心上型（Ⅰ型）11例，其中ⅠA型10例，ⅠB型1例，心内型（Ⅱ型）5例，其中ⅡA型2例，ⅡB型3例。11例经手术证实的TAPVC患者超声诊断及分型与手术结果一致，同时超声心动图还可以估计肺动脉压力，发现合并存在的其他畸形等。结论：超声心动图是TAPVC患者术前首选检查方法，如能多部位多切面仔细观察，则可对TAPVC作出准确的定性及分型诊断。

Echocardiographic diagnosis of total anomalous pulmonary venous connection

Objective To investigate the value of echocardiographic in diagnosis of total anomalous pulmonary venous connection (TAPVC). Methods Sixteen patients were diagnosed to have TAPVC by echocardiography from year 1994 to 2001, among whom the results of eleven cases of echocardiography were compared to those of surgery. Each patient was examined by using a combination of parasternal, suprasternal and subcostal windows to visualize all the pulmonary veins and their drainage sites, common pulmonary vein cavity, and associated abnormalities.Results Of the sixteen patients, the drainage sites were as follow: supracardia in ten, via vertical vein in nine, directly to superior vena cava in one; cardiac in five, via coronary sinus in two, directly to right atrium in three. Diagnosis were correctly made in all the eleven cases that were confirmed by surgery. Echocardiography can also assess pulmonary arterial pressure, detect other associated abnormalites.Conclusions Echocardiography is the preferred examination method in the diagnosis of TAPVC before surgery. With caregul examination using multiple windows and sections, TAPVC can be accurately diagnosed by echocardiography.