左冠状动脉异常起源于肺动脉的超声心动图诊断价值

目的:探讨左冠状动脉异常起源于肺动脉(ALCAPA)的超声心动图诊断价值。方法:以CTA和手术证实的16例ALCAPA患儿为研究对象,回顾分析其超声心动图表现特征。结果:16例中,超声首诊11例,误诊5例,5例均误诊为心内膜弹力纤维增生症(EFE),复诊检出3例,余2例最后经CTA检出,超声首诊正确率69%。其主要超声表现为:左冠状动脉主干异常开口于肺动脉;右冠状动脉扩张;左心室扩大;心内膜、二尖瓣腱索及乳头肌及回声增强。彩色多普勒显示左冠状动脉内血流为逆向灌注,肺动脉内舒张期见异常血流进入;室间隔可见异常交通循环血流信号。结论:ALCAPA具有特征性超声心动图表现,超声是早期诊断的重要手段。

Diagnostic value of echocardiography for deficiency of anomalous left coronary artery from the pulmonary artery

Objective:To explore the diagnostic value of echocardiography for the deficiency of anomalous left coronary artery from the pulmonary artery(ALCAPA).Methods:The clinical manifestations and echocardiographic features were analyzed in 16 cases of anomalous left coronary artery from the pulmonary artery by CTA and surgical findings.Results:In 16 cases,the first ultratrasound diagnosis is 11,5 cases of misdiagnosis,all the 5 cases were misdiagnosed as endocardial fibroelastosis(EFE),3 cases detercted by follow-up examination,the remaining 2 cases were detected by CTA,the correct rete of ultrasound first diagnosis was 69%.The main ultrasonic manifestations are as follows:the trunk of left coronary artery opens abnormally in the pulmonary artery,right coronary artery dilates,left ventricular enlargement,echocardiography was enhanced in endocardium mitral chordae tendineae and papillary muscles,color doppler flow shows reverse perfusion in the left coronary artery,abnormal blood flow was observed in the pulmonary artery during diastole,abnormal circulation blood flow signals can be seen in the ventricular septum.Conclusions:ALCAPA has characteristic echocardiographic manifestations,ultrasound is an important means of early diagnosis.