多发房间隔缺损经胸超声心动图与经食管超声心动图对比研究

目的 探讨经胸超声心动图(TTE)与经食管超声心动图(TEE)对多发继发孔房间隔缺损(MASD)的诊断价值.方法 应用TTE检查40例MASD,33例行TEE检查,30例行心导管检查,28例行MASD封堵术介入治疗,24例封堵成功,10例开胸体外循环下MASD修补治疗.结果 TTE与TEE全部诊断继发孔房间隔缺损,TTE诊断缺损数量准确率60%(24/40);TEE诊断缺损数量准确率97%(32/33).MASD的彩色多普勒血流显像(CDFI)特征性改变是显示多束过房间隔左向右五彩镶嵌分流束血流信号,似"漏勺样"改变,称CDFI"漏勺征".结论 TTE对MASD诊断有一定难度,TEE有特异性诊断价值.MASD开胸修补治疗行TTE检查即可,封堵术介入治疗必需行TEE检查,明确诊断缺损的数量和位置.

Comparison between Transthoracic and Transesophageal Echocardiography in Diagnosing Multiple Atrial Septal Defect

Objective To explore the value of transthoracic echocardiography(TTE)and transesophageal echocardiography(TEE)in diagnosing multiple atrial septal defect(MASD).Methods Forty cases of MASD were examined using TTE.Among them,33 cases underwent TEE and 30 cases underwent cardiac catheterization examination.Twenty-eight of the 40 cases were treated with transcatheter occlusion among which 24 cases were successful and,10 cases underwent open-chest operations.Results Foramen secundum atrial septal defect were diagnosed by both TTE and TEE.By the judgment of the number of atrial septal defect,TTE had an accuracy rate of 60%(24/40),and TEE 97%(32/33).The color Doppler flow imaging(CDFI)features of MASD showed multiple colorful left-to-right shunt signals through the atrial septal like "colander",designated as"colander sign"of CDFI atrial.Conclusions TTE has some difficulties and TEE has specific value in diagnosing MASD.TTE can be chosen before open-chest operation.TEE is necessary before transcatheter occlusion to make sure of the amount and location of atrial septal defect.