超声心动图对先天性右位心的诊断价值

目的　探讨超声心动图对先天性右位心的形态学特征以及合并畸形的诊断价值。方法　用超声心动图按 Van Praagh节段分析法对右位心心脏结构进行观察 ,结合 X-线进行诊断。结果　 93例右位心患者中镜像心 4 3例 ,右旋心 4 2例 ,右房异构 3例 ,左房异构 5例。镜像心大多各节段连接一致 ,心血管畸形中肺血多的主要为房间隔缺损 (ASD)和室间隔缺损 (VSD) ;肺血少的主要为法洛四联症 (TOF)、右室双出口 (DORV) 肺动脉狭窄 (PS)、单心室 (SV) PS。右旋心中大多各节段连接的不一致 ,且多合并肺血减少的复杂畸形 ,主要畸形为 DORV PS、矫正型大动脉转位 (C- TGA) PS、 SV PS、 TOF、肺动脉闭锁 (PAA)、大动脉转位 (TGA) PS。异构右位心大多各节段连接一致 ,大多合并肺血减少的复杂畸形。结论　先天性右位心各节段均可出现异常 ,多合并复杂心血管畸形 ,超声心动图能准确进行解剖学及血流动力学的诊断及评价 ,可作为首选或筛选方法。

Echocardiographic Diagnostic Value in Congenital Dextrocardia

Objective To evaluate the echocardiographic diagnostic value of congenital dextrocardia in morphologic characterization and cardiovascular anomalies Methods The types of dextrocardia were classified by Van Praagh's method,and the cardiovascular anomalies encountered were diagnosed by echocardiography combined with X ray Results Of total 93 patients,43 cases were with mirror image dextrocardia,42 cases were dextroversion,3 were right isomerism and 5 were left isomerism In mirror image dextrocardia,majority of patients had concordant segmental connection and presented anomalies with increased pulmonary blood,including ASD and VSD;the major anomalies with decreased pulmonary blood were TOF,DORV PS and SV PS In dextroversion,majority of patients had disconcordant segmental connection and presented with decreased pulmonary blood flow,including DORV PS,C TGA PA,SV PS,TOF,PAA and TGA PS In situs ambiguous dextrocardia,majority of patients had univentricular connection combined with complex anomalies Conclusions Congenital dextrocardia may present with abnormal segmental connections and complex anomalies Echocardiography can be the first choice for screening dextrocardia with anatomic and hemodynamic diagnosis