超声心动图与计算机断层扫描血管成像诊断儿童三房心及其预后分析

目的探讨超声心动图（Echo）、计算机断层扫描血管成像（CTA）诊断儿童三房心（CT）的临床应用价值并分析其预后。 方法以2009年5月至2019年5月重庆医科大学附属儿童医院手术治疗的49例CT患儿为研究对象，回顾性总结分析其Echo、CTA的影像学特征及患儿预后。 结果本组49例患儿，心脏位置正常者48例（98.0%），镜面右位心1例（2.0%）；左房三房心（CTS）47例（95.9%），右房三房心（CTD）2例（4.1%）。43例（87.7%）CTS和2例（4.1%）CTD均合并其他心脏畸形，常见合并的心脏畸形为房间隔缺损（71.4%）、肺静脉异位引流（28.6%）、室间隔缺损（24.5%），4例（8.2%）单纯CTS未合并其他心脏畸形。Echo漏诊CTS及合并心脏畸形10例（10/49），其中8例仅漏诊CTS；CTA漏诊CTS 6例（6/18），漏诊合并心脏畸形10例（10/18），相应的18例接受Echo和CTA的患儿，其Echo诊断符合率均为100%。Echo诊断CT及其合并心脏畸形的符合率均高于CTA（P均＜0.05）。手术治疗后治愈出院42例（85.7%），7例（14.3%）死亡。 结论Echo对CT及其合并心脏畸形的诊断优于CTA，二者联合可能对CT诊断及治疗具有重要价值。

Diagnosis of children with cor triatriatum with echocardiography and computed tomographic angiography and prognosis analysis

Objective To investigate the clinical application value of echocardiography Echo and computed tomographic angiography(CTA)in the diagnosis of cor triatriatum(CT)in children,and to analyze the prognosis.Methods A total of 49 CT children who underwent surgery at Children’s Hospital of Chongqing Medical University from May 2009 to May 2019 were selected as the research subjects.The imaging features of Echo and CTA were analyzed retrospectively,and the prognosis outcome were analyzed.Results There were 29 males and 20 females,with a male-to-female ratio of 1.45:1.Their median age was10 months and median body weight was 7 kg.There were 48(98.0%)cases with normal cardiac position,1(2.0%)with mirror dextrocardia,47(95.9%)with cor triatriatum sinister(CTS),and 2(4.1%)with cor triatriatum dexter(CTD).Forty-three(87.7%)cases of CTS and 2(4.1%)cases of CTD were combined with other cardiac malformations,and the common cardiac malformations were atrial septal defect(71.4%),anomalous pulmonary venous connections(28.6%),and ventricular septal defect(24.5%).Four(8.2%)cases had simple CTS without other cardiac malformations.Ten cases of CTS with other cardiac malformations were missed by echocardiography(10/49),6 cases of CTS were missed by CTA(6/18),10 cases with associated cardiac malformations were missed by CTA(10/18),both of the Echo diagnostic coincidence rates of CTS and its associated cardiac malformations in the 18 patients underwent echocardiography and CTA were 100%,which were higher than those by CTA(P<0.05).After operation,42(85.7%)cases were cured and 7(14.3%)died.Conclusion Echo is better than CTA in the diagnosis of CT and its associated cardiac malformations.The combination of the two may have important application value.