多普勒超声心动图诊断冠状动脉瘘的临床应用价值

目的：回顾并分析冠状动脉瘘（coronary artery fistula CAF）的多普勒超声心动图（Doppler echocardiography DE）诊断特点,探讨超声心动图对冠状动脉瘘诊断的临床应用价值。资料与方法：对13例已被证实的冠状动脉瘘超声心动图二维、彩色多普勒和连续多普勒图像资料进行回顾性的分析,并总结其超声图像特征及规律。结果：发现13例冠状动脉瘘中12例均做出正确的超声诊断,敏感性92％,特异性100％,多普勒超声心动图特征表现在以下方面：（1）右冠状动脉瘘且右冠－右心系统瘘者多见;（2）瘘入左心室瘘口血流表现为舒张期湍流外,而瘘入其它腔室时均为连续性双期湍流频谱;（3）瘘管及瘘口显示明确时,均可见异常明亮的彩色多普勒血流现象。结论：多普勒超声心动图对冠状动脉瘘诊断具有较高的临床应用价值。     

彩色多普勒超声诊断冠状动脉瘘的临床价值

经彩色多普勒超声心动图检查发现先天性冠状动脉瘘２１例，其中单发瘘口１９例，多发瘘口２例，所有病例均经手术和／或心血管造影证实。表明彩色多普勒超声心动图具有简便、安全、可靠的特点，是无创性诊断先天性冠状动脉瘘的首选方法。     

彩色多普勒超声诊断冠状动脉瘘的临床价值

经彩色多普勒超声心动图检查发现先天性冠状动脉瘘２１例，其中单发瘘口１９例，多发瘘口２例，所有病例均经手术和／或心血管造影证实，表明彩色多普勒超声心动图具有简便，安全，可靠的特点。是无创性诊断先天性冠状动脉瘘的首选方法。     

经胸彩色多普勒超声诊断冠状动脉瘘的临床价值

目的探讨先天性心脏病冠状动脉瘘（coronary artery fistula）的临床表现及经胸彩色多普勒超声心动图的诊断价值。方法回顾性分析32例CAF患者的临床表现及超声心动图特征。结果本组32例CAF患者超声诊断与冠状动脉造影及手术结果符合达100％。结论超声心动图对先心病CAF有较高的诊断价值，可作为首选检查方法。     

多普勒超声心动图诊断冠状动脉瘘的临床应用价值

目的:回顾并分析冠状动脉瘘(coronary artery fistula CAF)的多普勒超声心动图(Doppler echocardiography DE)诊断特点,探讨超声心动图对冠状动脉瘘诊断的临床应用价值。资料与方法:对13例已被证实的冠状动脉瘘超声心动图二维、彩色多普勒和连续多普勒图像资料进行回顾性的分析,并总结其超声图像特征及规律。结果:发现13例冠状动脉瘘中12例均做出正确的超声诊断,敏感性92%,特异性100%,多普勒超声心动图特征表现在以下方面:(1)右冠状动脉瘘且右冠-右心系统瘘者多见;(2)瘘入左心室瘘口血流表现为舒张期湍流外,而瘘入其它腔室时均为连续性双期湍流频谱;(3)瘘管及瘘口显示明确时,均可见异常明亮的彩色多普勒血流现象。结论:多普勒超声心动图对冠状动脉瘘诊断具有较高的临床应用价值。     

冠状动脉瘘的彩色多普勒超声心动图特征分析

目的 分析冠状动脉瘘的彩色多普勒超声心动图图像特征，探讨彩色多普勒超声心动图诊断冠状动脉瘘的价值。方法 应用彩色多普勒超声心动图对8例冠状动脉瘘的解剖位置及心腔内异常高速血流进行观察。结果 彩色多普勒超声心动图诊断冠状动脉瘘的共同特征：①异常交通的冠状动脉显著扩张，走行迂曲，开口大，瘘口小，可间断或全程显示瘘管。②心腔内异常高速血流。瘘入右心系统者，分流呈双期连续性血流，瘘入左心系统者分流仅见于舒张期。③单纯冠状动脉瘘时无论冠状动脉瘘入哪个心腔均可见左室扩大，主动脉根部内径增宽，瘘入右心者右室亦扩大。④右冠状动脉右心瘘多见，瘘入左心者少见。结论 冠状动脉瘘具有明显彩色多普勒超声心动图的图像特征。     

经胸彩色多普勒超声对先天性冠状动脉瘘的诊断价值分析

目的分析冠状动脉瘘的彩色多普勒超声心动图像特征,探讨经胸彩色多普勒超声心动图诊断冠状动脉瘘的价值。方法应用彩色多普勒超声的二维图像、多普勒频谱和彩色显像对26例冠状动脉瘘的解剖异常及心腔内异常高速血流进行观察。结果 26例患者中,超声诊断右冠状动脉瘘18例(69.2%),左冠状动脉瘘6例(23.1%),双侧冠状动脉瘘1例(3.8%)。超声心动图能清楚显示25例冠状动脉瘘的起源/走行和瘘口,超声诊断符合率为96.2%。结论彩色多普勒超声心动图对冠状动脉瘘的诊断有很高的实用价值,但对细小瘘口仍应结合冠状动脉造影检查。     

超声诊断冠状动脉瘘易误诊原因分析

目的 探讨超声心动图对冠状动脉瘘的诊断价值.方法 对笔者所在医院38例先天性冠状动脉瘘患者进行回顾性分析,所有患者均经冠状动脉造影和(或)手术确诊.结果 38例冠状动脉瘘患者超声诊断正确35例,均为单发瘘口,漏诊1例多发瘘口(2个瘘口)为单发,误诊两例分别为动脉导管未闭、主动脉窦瘤破裂.超声诊断冠状动脉瘘单发瘘口准确率为92.1%.结论 超声心动图对冠状动脉瘘具有较高的诊断价值,可作为首选的诊断方法.     

冠状动脉瘘的彩色多普勒超声诊断

目的　进一步提高超声对少见病的诊断水平。　方法　对 10例冠状动脉瘘的患者行彩色多普勒超声心动图检查。　结果　冠状动脉瘘 3例 ,冠状动脉左心室瘘 3例 ,冠状动脉右心室瘘及冠状动脉左室流出道瘘各 2例。　结论　彩色多普勒超声心动图能根据冠状动脉扩张、瘘管开口位置和舒张期血流等特点 ,对本病作出准确诊断     

彩色多普勒超声心动图诊断冠状动脉瘘

目的:探讨冠状动脉瘘的超声表现与临床诊断价值.方法:回顾性总结分析42例冠状动脉瘘的彩色多普勒超声心动图表现,本研究所有患者均经冠状动脉造影和(或)手术确诊.结果:42例冠状动脉瘘患者超声诊断正确39例,均为单发瘘口,漏诊1例多发瘘口(3个瘘口)为单发,误诊两例分别为川崎病、主动脉窦瘤破裂.超声诊断冠状动脉瘘单发瘘口准确率92.3%.结论:彩色多普勒超声心动图诊断冠状动脉瘘及其合并畸形直接、安全、快捷,具有重要的临床价值.     

法洛四联症的超声诊断分析

目的 探讨彩色多普勒超声对法洛四联症的诊断价值.方法 观察48例法洛四联症术前经胸超声心动图特征,并与手术结果进行对照,并超声观察法洛四联症术后发生小冠状动脉-右心室瘘情况.结果 48例法洛四联症患者均行手术治疗,误诊2例,漏诊2例,手术证实超声诊断符合率为92%.5例术后出现小冠状动脉-右心室瘘,发生率为10%.结论彩色多普勒超声诊断法洛四联症准确、快捷、无创,对其病理解剖和血流动力学可作出明确诊断,并且是评价法洛四联症患者术后小冠状动脉-右心室瘘的敏感方法.     

实时二维伪彩色多普勒探测心内分流

采用实时二维伪彩色多普勒新技术,对106例进行了临床研究:①心内分流组56例,包括58处病损(房间隔缺损21、室间隔缺损29、动脉导管未闭3、主动脉窦瘤破裂3和冠状动脉瘘2);②心内无分流组50例,包括正常人20名和瓣膜病30例。结果显示本技术对心内分流的探测敏感性与特异性均为100％,较其他各种超声检查技术为高,且可提供半定量诊断,检查省时,效率高。本组已手术的21例中,11例术前免除心导管检查,具有较大的社会效益。     

冠状动脉瘘的超声心动图诊断（附12例报告及文献复习）

目的通过回顾和文献复习,探讨超声心动图对冠状动脉瘘的诊断价值。方法分析12例冠状动脉瘘的超声心动图表现,其中5例升主动脉、冠状动脉造影和手术。结果冠状动脉瘘的超声瘘的超声心动图诊断与造影、手术结果相符。结论超声心动图能显示扩张的冠状动脉及走行以及瘘口血流状况,是诊断冠状动脉瘘的首选方法。     

超声与冠状动脉造影、左室造影的对照研究

目的 :通过超声与冠状动脉 (简称冠脉 )造影、左室造影的对照研究 ,探讨超声检测冠心病的临床价值。　方法 :正常人 2 0例 ,拟行冠脉旁路移植术组 18例 ,观察 :①应用彩色多普勒冠脉血流显像技术 (CAFI)显示并测定冠脉血流脉冲多普勒频谱值。②经超声心动图显示和测定室壁运动和左室射血分数。拟行冠脉旁路移植术组需行冠脉造影和左室造影。　结果 :应用CAFI左前降支 (LAD)的显像率最高。拟行冠脉旁路移植术组 12例与正常人 2 0例应用CAFI测LAD血流脉冲多普勒频谱值间差异非常显著 (P <0 .0 0 1或P <0 .0 1) ,两组间左回旋支的钝圆支、冠脉后降支血流脉冲多普勒频谱值无显著差异 (均P >0 .0 5 )。超声与左室造影对照研究中室壁运动异常的检出无显著差异 (P >0 .0 5 )。 2例单支LAD狭窄 >90 %且无侧支循环建立者 ,超声均发现室壁瘤 ,这 2例超声与左室造影等所测左室射血分数最低。　结论 :本研究显示 ,CAFI能直接观察冠脉血流 ,超声观察室壁节段性运动异常可推测相关冠脉病变 ,左室重构对左心功能影响最为明显     

彩超诊断先天性冠状动脉瘘患者心室瘘口的异常血流

目的探讨利用彩色多普勒超声诊断先天性冠状动脉瘘（congenital coronary artery fistula,CCAF）心室瘘口的异常血流的特点及价值。方法采用彩色多普勒超声分别在常规切面和特殊的心肌与心室的交界切面观察CCAF心室瘘口的结构及血流特点,分析总结漏入心室的CCAF的特点及诊断规律。结果 13例CCAF患者中,漏入左心室的6例,漏入右心室的5例,漏入双心室的2例。9例在常规切面行彩色多普勒检查可探及心室瘘口及瘘口异常血流;而13例CCAF患者均在心肌与心室交界切面发现心室内存在肌小梁,且瘘口异常血流由肌小梁间隙汇入心室。结论心肌与心室交界切面较常规切面可更有效的发现漏入心室的CCAF,提示本方法有助于减少CCAF患者的误诊及漏诊。     

Diagnostic value of dual-source CT in Kawasaki disease

Background Doppler color echocardiography is a common method for detecting coronary artery lesions in patients with Kawasaki disease（KD）.However,the diagnostic accuracy for the whole coronary artery lesions is limited.The purpose of this study was to compare the diagnostic value of dual-source computed tomography （DSCT） and Doppler color echocardiography for the assessment of coronary artery lesions caused by KD.Methods Sixteen patients,12 with typical KD and 4 with atypical KD,underwent DSCT and Doppler color echocardiography.The position and internal diameter of each coronary artery lesion was measured.Correlation analysis was used to compare the diagnostic value of the two imaging modalities.Results ln the typical KD group, seven patients did not have any coronary artery Iesion as confirmed by both DSCT scans and Doppler color echocardiography;in four patients proximal coronary artery injuries were identified by both modalities;in one patient an aneurysm in the middle and distal segments of the coronary artery was detected by DSCT but was negative in Doppler color echocardiography.In the atypical KD group,three cases showed the same results with both modalities,while one case with coronary artery stenosis in the middle segment was identified by DSCT but not detected by Doppler color echocardiography.There was a good correlation between the two imaging modalities（Kappa value,0.768（≥0.75））.Conclusion DSCT coronary artery angiography is an accurate,non-invasive,and valuable technique for detecting and following up coronary artery lesions in patients with KD.     

双源CT在川崎病诊断中的价值

Objective:To evaluate the diagnostic value of Dual-source CT for Kawasaki disease with coronary artery involvement. Methods:Dual-source CT scans, together with Doppler color echocardiography, was performed in the evaluation of 16 patients with Kawasaki diseases comprising 12 typical Kawasaki diseases and 4 atypical Kawasaki diseases. Results :Of the 12 typical Kawasaki disease, 7 cases were normal without coronary artery lesions as confirmed by both Dual-source CT scans and Doppler color echocardiography; 4 cases were detected by the both modalities, i.e., both two coronary artery dilatation in 1 case, coronary artery aneurysm in 2 cases and giant aneurysm with mural thrombus in 1 case; and 1 case clearly showed ectasia of both two coronary middle and distal segment in Dual-source CT but not in Doppler color echocardiography. While, of 4 atypical Kawasaki diseases, 3 cases showed the same result in Dual-source CT and Doppler color echocardiography, and the remaining 1 case was only identified by Dual-source CT but not detected by Doppler color echocardiography. Conclusions: Dual-source CT coronary artery angiography is a highly accurate and non-invasive technique, which possesses great value in diagnosing and following up of the patient with Kawasaki disease.     

SURGICAL TREATMENT OF CONGENITAL COTONARY ARTERY FISTULA REPORT OF TWO CASES

Two patients with congenital coronary artery fistula were treated surgically at our hospital in 1987. The fistulae originated from the left coronary artery. One patient was treated by direct ligation and the other by suture from within the left ventricle under cardiopulmonary bypass. The diagnosis and method of surgical treatment were discussed.