超声心动图诊断肺动脉夹层--附3例报告

目的初步评价超声心动图诊断肺动脉夹层的价值。方法结合文献，回顾性分析3例肺动脉夹层患者的经胸超声心动图表现。结果3例肺动脉夹层患者均为左向右分流的先天性心脏病患者，其中动脉导管未闭2例，房间隔缺损合并右肺静脉畸形引流1例，均合并重度肺动脉高压，肺动脉显著扩张。其中2例成功行肺动脉夹层缝闭术。超声心动图均能准确显示夹层发生部位、剥离的内膜及破口情况。结论肺动脉夹层是一种罕见且病程凶险的疾病，大部分患者合并原发或继发性肺动脉高压，肺动脉显著扩张。超声心动图是肺动脉夹层的首选影像学诊断方法。

Echocardiographic diagnosis of pulmonary artery dissection: three case reports

Objective To report three cases of pulmonary artery dissection that were primarily diagnosed by echocardiography and present an extensive review of the literature of pulmonary artery dissection, evaluate the value of echocardiography in the diagnosis of pulmonary artery dissection. Methods Echocardiography were carried out in three patients with pulmonary artery dissection,and its characteristics were analyzed combined with the references. Results All the three cases had congenital heart diseases with shunt from the left heart to the right, two of which had patent arterial ductus,and the third one,atrial septal defect with abnormal right pulmonary venous connection. Marked dilation of the pulmonary artery and severe pulmonary hypertension existed in all three cases. Site of the dissection,abradant endomembrane and its crevasse could be clearly seen by echocardiography. Conclusions Pulmonary artery dissection is a rare but life threatening disease, it often occurs in patients with pulmonary hypertension and dilation of the main pulmonary and/or branches. Echocardiography should be the first choice in the diagnosis of the pulmonary artery dissection.