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。

Evaluation of abnormal blood flow to ventricles in congenital coronary artery fistula by color Doppler echocardiography

Objective To probe the abnormal blood flow to ventricles in congenital coronary artery fistula（CCAF） by color Doppler echocardiography（CDE）.Methods Thirteen patients with congenital coronary artery fistula underwent CDE examinations.The features of structure and volume flow of the fistula in ventricles were observed by CDE with regular section and the section between myocardium and ventricular chambers.The features of blood flows into ventricles were evaluated.Results CDE showed that among 13 CCAF patients,flow into left ventricle in 7 cases; into right ventricle in 6 and into both ventricles in 2.The fistulas with abnormal volume flow were detected by regular section in 9 cases.The trabeculations in ventricles were observed with section between myocardium and ventricle in all 13 patients,and the volume flow into ventricles across the gap of the trabeculations was detected.Conclusion Echocardiographic section between myocardium and ventricular chambers is more likely to detect the flow into ventricles in CCAF patients than the regular methods,it would reduce the misdiagnosis and missed diagnosis.