成人矫正型大动脉转位的彩色多普勒超声心动图特征 及规律性研究

目的：探寻成人矫正型大动脉转位（CTGA）的彩色多普勒超声心动图（CDE）特征及规律性。方法：应用CDE检查40例成人CTGA，35例经心血管造影对照，38例经手术证实。结果：根据CDE特征表现，对39例做出正确诊断，诊断准确率97.5%，1例误诊为完全性大动脉转位。成人CTGA的CDE特征及规律性明显：①二维超声心动图（2DE）心尖四腔心切面所有患者均显示心房与心室连接不一致，其中SLL型显示心房正位、心室左袢；IDD型显示心房反位、心室右袢。②2DE胸骨旁大动脉短轴切面显示两条大动脉呈两个环状回声，称2DE“双环征”。通过两环相互位置关系可确定转位的类型，其中SLL型两个环状回声呈左前右后排列，IDD型两个环状回声呈右前左后排列；根据两个环状回声内径比较可判定是肺动脉狭窄（PS）还是肺动脉高压（PH），其中PS患者显示位于后方的环状回声明显小于位于前方的环状回声，PH患者显示位于后方的环状回声明显大于位于前方的环状回声。③合并房间隔缺损和室间隔缺损患者的彩色多普勒血流显像（CDFI）显示过房间隔和室间隔分流束血流信号不明显；合并房室瓣关闭不全和肺动脉狭窄患者的CDFI显示过房室瓣反流束血流信号和过肺动脉射流束血流信号明显。结论：成人CTGA的CDE特征及规律性明显，应用2DE判断心房与心室连接不一致和心室与大动脉连接不一致是诊断CTGA的关键，CDE对CTGA合并畸形诊断有一定难度，但对外科拟定手术方案有重要临床价值。

Study on imaging characteristics and regularity of adult corrected transposition of the great arteries in color Doppler echocardiography

Objective:To probe into the imaging characteristics and regularity of color Doppler echocardiography(CDE) with adult corrected transposition of the great arteries (CTGA). Methods:Forty patients with adult CTGA were examined by CDE, 35 cases had angiocardiography and 38 cases were proved by surgical operations. Result:Thirty-nine cases were properly diagnosed based on the CDE characteristics with diagnostic accuracy of 97.5%, 1 case was misdiagnosed as complete transposition of the great arteries. The CDE ch...