成人先天性冠状动脉瘘彩色多普勒超声心动图特征及规律性研究

目的 探寻成人先天性冠状动脉瘘彩色多普勒超声心动图(CDE)特征及规律性.方法 应用CDE检查31例成人先天性冠状动脉瘘,寻找CDE特征及规律性,26例经心血管造影对照,7例行介入治疗,24例经手术证实.结果 根据CDE特征对29例作出正确诊断,诊断准确率93.5%,对所有合并畸形全部作出正确诊断.成人先天性冠状动脉瘘的CDE特征及规律性明显:①二维超声心动图显示瘘的一支冠状动脉明显扩张;②无论哪支冠状动脉瘘至哪个心腔均显示左心房、左心室和主动脉根部内径增大;③彩色多普勒血流显像(CDFI)在瘘的心腔或肺动脉内显示异常血流束信号;④CDFI异常廊流束起始部宽度相当于瘘口直径;⑤冠状动脉瘘至右室多见,冠状动脉瘘至右心房、左心房、左心室和肺动脉少见,两支冠状动脉瘘罕见;⑥由于左心室收缩压与主动脉压相同,CDFI异常血流柬信号不明显,瘘至左心室或肺动脉容易误诊.结论 成人先大性冠状动脉瘘的CDE特征及规律性明显,CDE对成人先天性冠状动脉瘘有特异性诊断价值,但瘘至左心室或肺动脉容易误诊.

Imaging characteristics and regularity of adult congenital coronary artery fistula in color Doppler echocardiography

Objective To probe into the imaging characteristics and regularity of color Doppler echocardiography(CDE) in congenital coronary artery fistula(CAF) in adults. Methods CDE was used to examine 31 adult patients with CAF and the imaging characteristics and regularity were observed. Angiocardiography was performed in 26 cases. Seven of the 31 cases were treated interventionally and 24 of them surgically. Results Of the 31 patients, 29 were correctly diagnosed according to the CDE characteristics (diagnosis accuracy was 93.5%) and all the complicated anomalies were correctly diagnosed. artery is the origin and whichever heart chamber is the entry site of the fistula, the left atrium and the left showed abnormal blood flow signals in the heart chamber into which the fistula drained and in pulmonary drained into the right ventricle was more common than that into the right atrium, the left atrium, the left or the pulmonary artery was easily misdiagnosed because left ventricular systolic pressure was equal to aortic pressure which made the abnormal blood flow in CDFI indistinct. Conclusions CDE showed obvious imaging characteristics and regularity for CAF in adults and has specific value for the diagnosis of this disease. But CAF that drained into the left ventricle or the pulmonary artery is easily misdiagnosed.