超声心动图与手术对室间隔缺损位置及大小误差原因分析

目的评价超声心动图对室间隔缺损(VSD)定位诊断和缺口大小定量诊断的准确性。方法将118例VSD患者按照解剖学进行超声分型及测值,其结果与手术结果进行对照。结果118例VSD按照广义粗略分型,超声符合率为98.3%;按照精确分型,超声符合率为83%。其中单纯膜部型易误诊为嵴下型,隔瓣下型和干下型易诊为膜周型。超声测量VSD大小与手术所见室缺大小有部分差异,差异较显著的是膜部VSD。结论超声心动图对VSD定位诊断有较高的准确率,对VSD大小的测量有部分差异,人体组织三维构像与超声二维切面的差异、“漏斗样”缺损、观察者径路、缺损边缘脱垂以及人为因素等,是造成超声与手术之间误差的原因。

Causes of error in assessing location and size of ventricular septal defect by echocardiography: comparing with surgical findings

Objective To evaluate the accuracy of echocardiography in assessment of the location and size of ventricular septal defect (VSD) . Methods According to anatomic classification, the location and size of VSD in 118 patients were determined by echocardiography, which were compared with surgical findings. Results The accuracy rate of ultrasound diagnosis was 98.3 according to cursory classification. The accuracy rate of ultrasound diagnosis was 83 based on accurate classification. The size of VSD detected by echocardiography was overvalued compared with that of surgical findings, and membranous VSD had remarkable difference between the result on echocardiography and that in surgery. Conclusion Echocardiography had higher accuracy rate in locating VSD, and the difference between three-dimensional configuration and planar image, the bugle-like defect, the route of observer, the prolapse of defect verge, artificial factors and etc, were the causes of the error in assessing VSD with echocardiography.