血管内超声评价先天性心脏病合并肺动脉高压肺血管病理变化的初步探讨

目的 :探索血管内超声在合并肺动脉高压的先天性心脏病 (先心病 )患儿肺动脉内检查的可行性并评价肺血管病理变化。　　方法 :对 6例合并肺动脉高压的先心病患儿进行肺动脉血管内超声检查 ,观测其管腔大小、内膜和中层的厚度以及血管的搏动性 ,同时与右心导管血液动力学在吸氧前后的变化结果进行了比较。　　结果 :肺动脉内超声能够清晰观测到其管壁的三层组织学变化 ,中层增厚 ,吸氧后肺动脉搏动性明显增强 ,与右心导管血液动力学检查结果有高度相关性。　　结论 :血管内超声对肺动脉的检查安全可靠 ,检查结果能够较好的反映肺动脉形态学变化。

Evaluation of Pulmonary Artery Pathology in Children with Congenital Heart Disease and Pulmonary Hypertension by Intravascular Ultrasound

Objective:To evaluate the feasibility of intravascular ultrasound(IVUS)techniques in children with congenital heart disease(CHD)and pulmonary hypertension and to assess simultaneously the pathology of pulmonary artery. Method:IVUS imagings were performed in 6 children with CHD and pulmonary hypertension undergoing cardiac catheterization.Luminal diameter,area,and pulsability were determined and pulmonary vascular reaction to 100% oxygen inhalation was studied. Result:Three layers pulmonary wall morphology could be clearly show with IVUS studies in children with pulmonary hypertension and the middle layer was thickened.Pulsability increased after inhaling 100% oxygen and was related to the dynamics in cardiac catheterization. Conclusion:IVUS imaging of the pulmonary vasculature is feasible in children and provides a good way to assess pulmonary morphology.