超声诊断复杂心脏畸形心室襻及心室手型

目的 分析不同类型复杂先天性心脏病(先心病)心室襻的图像特征,探讨应用超声心动图判定心室襻或心室手型的方法学及价值。方法 回顾性分析45例复杂先心病患者的超声图像,包括右心室双出口7例,完全型大动脉转位5例,矫正型大动脉转位11例,解剖矫正型大动脉异位2例,单心室15例,十字交叉心4例和楼上楼下心室1例。全部病例均由外科手术或CT检查证实。结果 7例右心室双出口中,心室右襻4例,心室左襻3例。5例完全型大动脉转位均为心室右襻。11例矫正型大动脉转位患者中,心室右襻1例,心室左襻10例。2例解剖矫正型大动脉异位患者均为心室右襻。15例单心室患者中,心室右襻8例,心室左襻4例,心室不定襻3例。4例十字交叉心和1例楼上楼下心室中,右手型心室3例,左手型心室2例。结论 超声心动图对复杂先心病的心室襻或手型定位具有重要价值,超声判定心室手型可以帮助分析复杂的心室构型。

Echocardiographic determination of ventricular loop or ventricular hand pattern topology for complex congenital heart diseases

Objective To discuss echocardiographic role and disciplines of ventricular loop or ventricular hand pattern topology in patients with complex congenital heart diseases (CHD). Methods The echocardiograms of 45 patients with complex CHD, including double-outlet right ventricle (DORV, n=7), complete transposition of great arteries (TGA, n=5),corrected transposition of the great arteries (CTGA, n=11), anatomically corrected malposition of the great arteries (ACMGA, n=2), single ventricle (SV, n=15), criss-cross heart (CCH, n=4) and superoinferior ventricles (n=1) confirmed by CT and operation were analyzed retrospectively. Results Ventricular dextro-loop was diagnosed in 4 patients of DORV, 5 patients of TGA, 1 patient of CTGA, 2 patients of ACMGA and 8 patients of SV. Ventricular levo-loop was diagnosed in 3 patients of DORV, 10 patients of CTGA and 4 patients of SV. Ventricular X-loop was diagnosed in 3 patients of SV. Three patients of right-hand topology and 2 of left-hand topology were diagnosed in patients with CCH or superoinferior ventricles. Conclusion Echocardiography is valuable for determination of ventricular loop or ventricular topology in diagnosis of complex CHD.Segmental analysis and the use of ventricular hand pattern topology by echocardiography are essential to define the ventricular anatomy of complex CHD.