多普勒超声心动图诊断部分性肺静脉异位引流

目的:评价多普勒超声心动图诊断部分性肺静脉异位引流(PAPVC)的价值。方法:回顾分析132例经心外科手术确诊为PAPVC患者的超声心动图诊断情况。结果:根据Brody分型,132例患者中A型14例,超声诊断11例,诊断正确率78.6%;B型103例,超声诊断57例,正确率55.3%;C型4例,超声诊断3例,诊断正确率75%;D型3例,混合型8例,术前超声均未能做出正确诊断。132例患者中右侧肺静脉异位引流90.1%;左侧肺静脉异位引流7.4%,双侧占2.5%。合并房间隔缺损(ASD)121例(91.7%),其中静脉窦型ASD 40例(33.1%),功能性单心房(大型ASD)或单心房18例(14.9%),继发孔型ASD 63例(52%);9例房间隔完整(6.8%),2例冠状静脉窦隔缺损(1.5%)。结论:彩色多普勒超声心动图可以清晰显示肺静脉的回流情况,准确诊断PAPVC。

The diagnosis of partial anomalous pulmonary venous connection by Doppler echocardiography

Objective:To evaluate the value of Doppler echocardiography in diagnosing partial anomalous pulmonary venous connection(PAPVC).Methods:A retrospective echocardiography review of 132 patients with PAPVC confirmed by surgical operation.Results:According to Brody's classification.11/14 patients(78.6%) with type A PAPVC were diagnosed accurately by Doppler echocardiography.57/103 patients(55.3%) with type B were diagnosed.3/4 patients(75%) with type C were diagnosed.3 patients with type D and 8 patients with mixed type were unconfirmed by Doppler echocardiography.Amorg the 132 patierts,that of right anomalous pulmonary venous connection covers 90.1%,left anomalous pulmonary venous connection 7.4% and bilateral cases 2.5%.The most common associated anomaly was an atrial septal defect(ASD) in 121 patients(91.7%),40 patients(33.1%) having sinus venous ASD,18 patients(14.9%) having large ASD or single atrium,63 patients(52%) having secondary ASD,9 patients(6.8%) had an intact atrial septum.2 patients (1.5%) having partial sinus septal defects.Conclusion:The reflux of pulmonary vein and the continuity of atrial septeum could be demonstrated and PAPVC could be diagnosed accurately by Doppler echocardiography.