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周锋王宏伟李晓彦李延会 《临床超声医学杂志》2017,19(3):211-212
目的 探讨多切面联合在产前超声诊断胎儿永存左上腔静脉中的价值。方法 对胎儿超声心动图诊断的12例胎儿永存左上腔静脉进行回顾分析。结果 12例胎儿永存左上腔静脉中10例伴冠状静脉窦扩张; 2例不伴冠状静脉窦扩张。结论 采取多切面联合诊断能提高PLSVC的检出率。 相似文献
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目的 总结永存左上腔静脉胎儿超声心动图特征及临床意义.方法 对2008年5月至2011年1月在我院诊断为永存左上腔静脉的33例胎儿超声心动图表现进行总结分析,并与引产后病理或产后超声心动图诊断结果进行对照分析,总结永存左上腔静脉胎儿超声心动图特征及临床价值.结果 33例永存左上腔静脉胎儿中引产后病理或产后超声心动图证实32例,超声表现为:四腔观可见扩张的冠状静脉窦,三血管观在肺动脉左侧可见一圆形血管回声,为永存左上腔静脉,同时可见右上腔静脉变细,追踪走行可见其与冠状静脉窦相连续.其中18例为单发畸形(18/32,56.25%),14例合并其他畸形(7例合并心内畸形,2例合并心外畸形,5例同时合并心内和心外畸形).胎儿超声心动图将内脏反位综合征合并完全型房室间隔缺损误诊为同时合并永存左上腔静脉1例.结论 胎儿超声心动图是诊断永存左上腔静脉的可靠方法.永存左上腔静脉常合并其他畸形,产前超声发现永存左上腔静脉需进一步检查以排除其他合并畸形. 相似文献
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产前超声诊断胎儿永存左上腔静脉 总被引:4,自引:0,他引:4
目的 探讨产前超声诊断胎儿永存左上腔静脉的临床价值.方法 回顾性分析21例经胎儿超声检查诊断为永存左上腔静脉的超声资料与随访结果,分析总结胎儿永存左上腔静脉各切面异常声像图特点.结果 12例胎儿经尸体解剖证实为永存左上腔静脉,胎儿永存左上腔静脉的主要声像图特征是胎儿心脏三血管切面观,肺动脉左侧多一条血管.冠状静脉窦扩张有助于诊断.结论 产前超声检查是诊断永存左上腔静脉的首选方法,有重要临床意义. 相似文献
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目的探讨超声心动图诊断冠状静脉窦(CS)区病变的价值。方法回顾性分析了13例相关患者的超声心动图诊断,其中9例进行了术后诊断对照。结果11例CS增宽,主要有永存左上腔静脉、完全型肺静脉异位引流、左冠状动脉-冠状静脉瘘等;1例右冠状动脉-右房瘘;1例右冠状动脉假性动脉瘤误诊为冠状静脉窦内实质性团块。结论CS区病变较多,超声心动图显像清晰,诊断信息丰富,应作为首选的检查手段。 相似文献
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超声心动图诊断胎儿冠状静脉窦扩张 总被引:1,自引:1,他引:1
目的 探讨超声心动图诊断胎儿冠状静脉窦扩张及其相关疾病的临床意义.方法 2010年1月-2012年4月19 914名孕妇于我院接受产前超声心动图检查.回顾性分析其中冠状静脉窦扩张胎儿的超声心动图表现及其合并相关疾病的特点.结果 共检出54胎冠状静脉窦扩张胎儿,均合并永存左上腔静脉;其中12胎合并其他心内畸形,3胎合并心外异常,6胎同时合并心内、心外异常.结论 产前超声对冠状静脉窦扩张及其相关疾病具有重要诊断价值和临床意义. 相似文献
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目的探讨时间-空间关联成像(STIC)联合B-flow在胎儿永存左上腔静脉产前超声诊断中的应用价值。方法对产前胎儿常规二维超声心动图可疑或明确心脏畸形的132例胎儿进行B-flow显像及STIC数据采集,观察有无左上腔静脉,并将产前超声诊断结果与产后新生儿超声心动图及引产后胎儿尸体解剖病理检查结果进行对比分析。结果 132例胎儿中120例在B-flow显像模式下STIC数据采集成功,采集成功率为90.9%(120/132);120例STIC数据采集成功的胎儿中,常规二维超声心动图诊断永存左上腔静脉15例(15/20)。B-flow-STIC诊断永存左上腔静脉20例。其中5例伴无名静脉缺如,4例合并心脏严重复杂畸形(2例合并完全性房室间隔缺损,1例合并三尖瓣发育不良,1例合并右心室双出口,1例合并右位主动脉弓,5例合并室间隔缺损),6例为单纯性永存左上腔静脉。B-flow-STIC修正常规二维超声心动图诊断5例;其中2例常规二维超声心动图诊断为房间隔缺损,1例常规二维超声心动图诊断为完全性房室间隔缺损,1例常规二维超声心动图诊断为心内型肺静脉异位引流,均经B-flow-STIC修正诊断为永存左上腔静脉;1例常规二维超声心动图漏诊,B-flow-STIC诊断为永存左上腔静脉引流至左心房。结论 STIC联合B-flow可清晰显示胎儿永存左上腔静脉及其空间位置关系,有利于提高永存左上腔静脉产前超声诊断准确性。 相似文献
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超声心动图诊断左上腔静脉合并先天性心脏病 总被引:1,自引:0,他引:1
目的:探讨超声心动图方法诊断左上腔静脉合并先天性心脏病的诊断价值。方法:17例临床诊断或怀疑先天性心脏病的患进行超声心动图检查,冠状静脉窦有扩张的患同时进行超声声学造影检查,以明确有否存在左上腔静脉异位引流。结果:本组17例患存在左上腔静脉合并先天性心脏病,13例患冠状静脉窦扩张,经超声心动图及超声声学造影确诊,4例先天性心脏病患漏诊左上腔静脉。13例患进行了手术治疗。结论:超声心动图的检查发现冠状静脉窦有扩张时,超声声学造影进一步检查可确诊有否存在左上腔静脉异位引流。 相似文献
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《临床超声医学杂志》2017,(3)
目的探讨胎儿冠状静脉窦扩张及其合并心内外畸形的产前超声诊断特点。方法回顾性分析我院经超声诊断的202例冠状静脉窦扩张胎儿,并与出生后随访或引产后病理解剖结果进行对照分析。结果 202例冠状静脉窦扩张胎儿中,合并永存左上腔静脉194例(96.0%),肺静脉异位引流4例,无顶冠状静脉窦1例,同时合并永存左上腔静脉及肺静脉异位引流1例,余2例为单纯冠状静脉窦扩张。其中合并其他畸形78例(38.6%),包括永存左上腔静脉合并其他心内畸形52例,合并心外畸形17例,合并心内外畸形7例;肺静脉异位引流合并其他心内畸形1例;无顶冠状静脉窦合并其他心内畸形1例。结论永存左上腔静脉是胎儿冠状静脉窦扩张的主要原因,其中室间隔缺损、肺动脉狭窄及法洛四联症是其最常见的并发心内畸形。产前超声在胎儿冠状静脉窦扩张及合并心内外畸形鉴别诊断中具有重要意义。 相似文献
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目的 探讨胎儿冠状静脉窦扩张的原因及其相关疾病中的超声诊断与鉴别.方法 回顾性研究我院就诊的11例胎儿冠状静脉窦扩张者,观察其冠状静脉窦的大小、血流特点;在左心房内寻找有无肺静脉;对左位上腔静脉进行追踪观察,与出生后或引产后进行随访检查对照.结果 11例冠状静脉窦扩张胎儿中,完全肺静脉异位引流(心中型)1例;永存左位上腔静脉8例,余2例心腔大小未见异常,找到2条肺静脉,出生后亦未见异常,经超声检查确诊为部分性肺静脉异位引流.结论 超声对胎儿冠状静脉窦扩张及其相关的完全性肺静脉异位引流、永存左位上腔有重要的诊断意义,但对部分性肺静脉异位引流尚不能确诊. 相似文献
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目的探讨超声心动图对永存左位上腔静脉引流入左房的诊断价值。方法对我院行超声心动图检查并经手术证实的13例永存左位上腔静脉(PLSVC)引流入左房病例进行了回顾性分析,总结不同引流途径的超声表现并与手术结果相对照。结果PLSVC直接开口于左房8例,PLSVC接冠状静脉窦(CS)合并CS终末段缺如者3例,PLSVC接CS合并CS中间段缺损者1例,PLSVC接CS合并CS中间、终末段均缺损者1例。7例行右心超声造影。超声正确诊断6例,误诊或漏诊7例。其中8例Raghib综合征漏诊4例,3例PLSVC接CS合并CS终末段缺如仅诊断为PLSVC2例,误诊为Raghib综合征1例。结论超声心动图结合右心超声造影可作为PLSVC引流入左房患者术前诊断的首选和筛选方法。 相似文献
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L A Podolsky L E Jacobs M Schwartz M N Kotler A Ioli 《Journal of the American Society of Echocardiography》1992,5(2):159-162
Three patients with suspected persistent left superior vena cava (PLSVC) diagnosed by transthoracic echocardiography underwent single-plane transesophageal echocardiography. In all three patients transverse cuts through right atrium and coronary sinus demonstrated the presence of PLSVC. Agitated contrast injection into the left antecubital vein opacified PLSVC and coronary sinus in all cases. Transesophageal echocardiography is superior to transthoracic echo in the diagnosis of PLSVC and associated cardiac anomalies. 相似文献
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目的 评价MSCT诊断永存左上腔静脉(PLSVC)的价值.方法 回顾性分析4例经临床证实PLSVC的成人患者MSCT图像特征.结果 4例成人PLSVC全部为Ⅰ型,颈静脉与锁骨下静脉汇合成垂直静脉后向下走行汇入右心房冠状静脉窦.4例患者冠状静脉窦增宽,平均为17.72mm.4例患者右侧上腔静脉均存在,与PLSVC间无交通支.结论 MSCT检查准确性高,能详细显示PLSVC走行等细节情况,是一种无创、方便、实用的检查手段,对于PLSVC的诊断具有特殊意义. 相似文献
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目的:研究超声心动图及声学造影诊断永存左上腔静脉(PLSVC)的敏感性并探讨提高其检出率的方法。方法:对23例经手术证实的先心病合并PLSVC的患者与经胸、经食道超声心动图(TTE、TEE)及声学造影进行回顾性对比分析。结果:在23例手术证实合并PLSVC的先心病患者中,术前经超声心动图及声学造影检出22例,占96%。结论:多切面的仔细观察及声学造影,多数患者可经超声心动图及声学造影在术前检出,为外科手术提供更多的信息以指导手术。 相似文献
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Background: Persistent left superior vena cava (PLSVC) is a congenital anomaly with an estimated incidence of 0.3–0.5% in the normal population. Its usual discovery is often made by an abnormally positioned catheter inserted in the left subclavian or left jugular vein. In this situation, an easy bedside approach to confirm an anatomic variation in the central venous system is helpful. In the majority of cases, the PLSVC drains to the coronary sinus. Objective: To describe the contribution of bedside echocardiography in diagnosing the unstable patient in whom there is suspicion of a PLSVC. Case Report: A 29-year-old man underwent an emergent laparotomy for multiple intra-abdominal abscesses. Postoperatively, after insertion of a central line catheter through the left subclavian vein, a chest X-ray study showed the tip of the catheter in a left paramediastinal position instead of crossing the midline to the superior vena cava. A PLSVC was suspected. The patient was hemodynamically unstable; therefore, a bedside non-invasive confirmation of the diagnosis of PLSVC was preferred. A transthoracic echocardiography study was performed after injection of agitated saline (creating air-filled microbubbles by shaking saline solution in a syringe), which showed that the coronary sinus was opacified, confirming the diagnosis of a PLSVC. Conclusion: In this brief report, we describe the contribution of echocardiography to the diagnosis of a PLSVC. Echocardiography is a reliable and easy diagnostic tool that allows a bedside approach in a patient in whom there is suspicion of a PLSVC, without administration of radiographic contrast. 相似文献
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目的探讨超声心动图对无脾综合征腔静脉回流的诊断价值,分析其漏误诊原因,以提高诊断准确率。方法回顾分析277例无脾综合征患儿腔静脉回流的超声心动图表现,并与其心血管造影或磁共振检查结果进行对照分析。结果 277例无脾综合征患儿中,双侧上腔静脉151例(54.5%),右侧上腔静脉79例(28.5%),左侧上腔静脉47例(17.0%)。上腔静脉回流超声诊断符合者268例(96.8%),下腔静脉回流超声诊断符合者243例(87.7%)。277例患儿中,34例肝静脉直接回流至心房(12.3%),超声心动图均未予诊断。结论超声心动图可以较准确地诊断无脾综合征腔静脉的回流,但对于肝静脉回流的诊断尚待进一步提高。 相似文献
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Luik A Deisenhofer I Estner H Ndrepepa G Pflaumer A Zrenner B Schmitt C 《Pacing and clinical electrophysiology : PACE》2006,29(2):171-174
Background: Atresia of the coronary sinus (CS) ostium with retrograde drainage of the cardiac veins via the persistent left superior vena cava (PLSVC) is a rare abnormality and only a few case reports in association with electrophysiological studies have been reported.
Methods: During standard electrophysiological study in three patients with a focal left atrial tachycardia, atrial fibrillation and common type right atrial flutter, the CS could not be cannulated despite several attempts. Assuming an occluded CS ostium we advanced a multipurpose catheter via the right atrium and the right superior vena cava in a PLSVC and performed CS angiography.
Results: CS angiography showed that the CS was occluded in all 3 patients and the PLSVC was used as a drainage route to the superior vena cava. After retrograde placement of a 2.5 Fr nonsteerable diagnostic catheter via the PLSVC in the CS, the intracardiac CS electrogram was recorded. Successful ablation could be performed in all three cases.
Conclusions: The cases highlight the possibility that failure to access the CS during electrophysiological studies may be related to this anomaly and that retrograde cannulation via PLSVC enables the CS access and acquisition of its electrograms. 相似文献
Methods: During standard electrophysiological study in three patients with a focal left atrial tachycardia, atrial fibrillation and common type right atrial flutter, the CS could not be cannulated despite several attempts. Assuming an occluded CS ostium we advanced a multipurpose catheter via the right atrium and the right superior vena cava in a PLSVC and performed CS angiography.
Results: CS angiography showed that the CS was occluded in all 3 patients and the PLSVC was used as a drainage route to the superior vena cava. After retrograde placement of a 2.5 Fr nonsteerable diagnostic catheter via the PLSVC in the CS, the intracardiac CS electrogram was recorded. Successful ablation could be performed in all three cases.
Conclusions: The cases highlight the possibility that failure to access the CS during electrophysiological studies may be related to this anomaly and that retrograde cannulation via PLSVC enables the CS access and acquisition of its electrograms. 相似文献
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17例永存左上腔静脉畸形的超声检查与手术对比分析 总被引:3,自引:0,他引:3
对17例经手术证实的先心病合并永存左上腔静脉畸形(LSVC)的患者进行回顾性对比分析,研究超声心动图诊断LSVC的敏感性并探讨提高其检出率的方法。发现在17例已证实合并LSVC的多种先心病患者中,术前经胸超声心动图检出LSVC12例,占71%,胸骨上窝探查有特异表现。后回顾复习患者资料,作者认为多切面的仔细探查,绝大多数患者可用经胸超声心动图在术前检出,可为外科手术提供更多的信息,以指导手术 相似文献