部分型肺静脉异位引流的超声诊断与手术结果对比分析

目的 通过分析超声诊断和手术结果，提高分型肺静脉异位引流（PAPVC）的超声诊断水平。方法 回顾性分析48例PAPVC患者的超声诊断，并与手术结果为对照。结果 本组48例中超声心动图提示PAPVC34例，其中26例PAPVC的类型引流途径与手术结果完全相符，8例部分相符。另有14例超声漏诊PAPVC，仅诊为房间隔缺损（ASD）。超声和手术均发现ASD45例，但超声对ASD类型判断与手术误差较大，而对PAPVC合并的其它畸形均诊断正确。结论 超声对PAPVC大部分可做出诊断，对部分异位引流右房的肺静脉的数目及走行可做出准确判断，对肺静脉开口显示不清的病例，易误诊为单纯的ASD。本文提示当发现ASD时，就高度警惕肺静脉入口的位置及血流方向。

Echocardiographic Diagnosis of Partial Anomalous Pulmonary Venous Connection Compared with Operation

Objective To improve the diagnosis of partial anomalous pulmonary venous connection (PAPVC) by comparing echocardiographic results and surgical findings. Methods 48 patients with PAPVC proven by surgery were analyzed ret rospectively. The preoperative echocardiographic findings were compared with the surgical findings. Results Echocardiog ram had indicated 34 cases suffered from PAPVC, 26 cases of which coincided completely with the surgical findings in the anomalous pulmonary venous number and returned pattern, and the other 8 cases coincided partly. There were 14 patients were misdiagnosed by echocardiography. In this group, 45 cases were found as coexistent atrial septal defect (ASD) both by echocardiography and surgery. But surgery identified that the position of ASD were partly different with the echocardiographic result. In addition,other coporate malformations of heart found by echocardiography were confirmed to be existent by operation. Conclusion Echocardiography could show correctly the majority of PAPVC and indicate partly the anomalous pulmonary venous number and returned pattern. However, it is possible that echocardiography misdiagnose PAPVC as simple ASD in the case that pulmonary veins were not showed clear by echocardiogram. This study demonstrated that in the patients of ASD the pulmonary venous number and their flow should be examinated routinely and carefully. [