超声心动图诊断不典型冠状动脉-肺动脉瘘的回顾性分析

目的探讨彩色多普勒超声心动图诊断不典型冠状动脉-肺动脉瘘的方法与临床应用价值.方法回顾6例冠状动脉瘘患者的超声心动图检查结果,并与手术和/或冠状动脉造影结果进行对照分析总结.结果 6例患者中4例为冠状动脉-肺动脉瘘,超声心动图观察1例典型病例清晰显示瘘管、瘘口及瘘管内血流频谱,临床表现为典型心肌缺血症状;另3例不典型病例只显示瘘口血流信号,未能显示完整瘘管及频谱,临床无特异症状.余2例为冠状动脉-右室瘘.6例患者中4例经冠状动脉造影证实,2例经手术证实.结论通过适当的方法和仔细地观察,可以明显提高超声诊断不典型冠状动脉-肺动脉瘘的阳性率;超声心动图检查具有较高的诊断价值,可以作为诊断冠状动脉-肺动脉瘘的首选诊断方法.

Retrospective Analysis of Echocardiography in Atypical Coronary Artery-Pulmonary Artery Fistula

Objective To explore the value of clinical echocardiographic application in the diagnosis of atypical coronary artery-pulmonary artery fistula(CA-PAF).Methods All 6 patients were diagnosed on echocardiography,and were compared with surgery and/or coronary artery angiography.Results Four of all 6 cases were with CA-PAF,1 of the 4 cases was typical,the fistula and orifice were traced and the blood flow characteristics were observed using pulsed-wave Doppler;3 of the 4 cases were atypical CA-PAF and the blood flow characteristics of the orifice were observed using color Doppler flow imaging(CDFI),which did not provide the precise localization of the whole fistula and the blood flow Doppler One of the 6 cases was with right ventricular fistula and 1 case was with right ventricular outflow fistula Four of the 6 patients were validated by coronary artery angiography and 2 cases were validated by surgery.Conclusions With the proper way and careful examination,the positive echocardiographic diagnostic rate of atypical CA-PAF will be raised obviously Echocardiography is also a primary method with high value for defining atypical CA-PAF.