先天性血管环的超声心动图诊断价值及漏诊分析

发布时间：2018-03-08 00:34

本文选题：超声心动图　切入点：血管环　出处：《中国超声医学杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的评价彩色多普勒超声心动图对先天性血管环(CVR)的诊断价值,分析超声心动图漏诊的原因,旨在提高其对CVR诊断的准确率。方法回顾性分析103例经外科手术证实为CVR患儿的经胸超声心动图资料,以手术结果为标准,与手术、CTA对比分析其声像图特点。结果 103例CVR构成类型:肺动脉吊带61例,超声心动图诊断准确率96.7%(59/61),漏诊率3.3%(2/61);双主动脉弓21例,超声心动图准确率57.1%(12/21),漏诊率42.9%(9/21);右位主动脉弓伴迷走左锁骨下动脉19例,超声心动图诊断准确率15.8%(3/19),漏诊率84.2%(16/19),左位主动脉弓伴迷走右锁骨下动脉2例,上述血管环畸形CTA全部诊断。103例CVR中伴有心内畸形77例,超声心动图全部诊断,而CTA漏误诊率11.7%(9/77)。结论超声心动图对于诊断肺动脉吊带及心内畸形的灵敏度高,但对双主动脉弓及迷走锁骨下动脉畸形易漏诊;与CTA结合能更好地明确血管环病变的组成及气管形态异常,为手术计划提供完整的信息。
[Abstract]:Objective to evaluate the value of color Doppler echocardiography in the diagnosis of congenital vascular annulus (CVR) and to analyze the causes of missed diagnosis by echocardiography. Methods the data of transthoracic echocardiography in 103 children with CVR confirmed by surgery were analyzed retrospectively. Results the imaging features of CVR were compared with that of surgical operation. Results the CVR was composed of pulmonary artery sling in 61 cases, echocardiographic accuracy of 96.759 / 61D, missed diagnosis rate of 3.3% / 61g, double aortic arch (21 cases), double aortic arch (21 cases), double aortic arch (21 cases), double aortic arch (21 cases), double aortic arch (21 cases), and double aortic arch (21 cases). The accuracy rate of echocardiography was 57.112 / 21, and the rate of missed diagnosis was 42.9 / 21. In 19 cases of right aortic arch with vagal left subclavian artery, the accuracy rate of echocardiography was 15.810 / 19, the missed diagnosis rate was 84.22% 16 / 19%, and the left aortic arch accompanied by right subclavian artery was lost in 2 cases. 77 cases of CVR were diagnosed by echocardiography, and the misdiagnosis rate of CTA leakage was 11. 7% / 77%. Conclusion Echocardiography has high sensitivity in the diagnosis of pulmonary artery sling and intracardiac malformation. However, double aortic arch and vagal subclavian artery malformation are easy to be missed, combined with CTA can better identify the pathological composition of vascular ring and abnormal tracheal morphology, and provide complete information for the operation plan.
【作者单位】：广州市妇女儿童医疗中心心脏功能诊断室;广州市妇女儿童医疗中心放射科;广州市妇女儿童医疗中心心脏中心;
【分类号】：R540.45;R725.4

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