超声心动图对儿童先天性单侧肺动脉缺如的诊断价值

发布时间：2018-03-09 11:33

本文选题：肺动脉　切入点：先天畸形　出处：《中国医学影像学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的单侧肺动脉缺如是罕见的先天性肺血管发育异常,因症状不典型易漏误诊。本研究探讨超声心动图对小儿先天性单侧肺动脉缺如(UAPA)的诊断及随访价值。资料与方法回顾性分析2009年5月—2016年7月广州市妇女儿童医疗中心经手术或CT血管造影(CTA)证实的35例UAPA患儿的超声心动图图像,对超声心动图诊断正确及漏误诊的图像特征进行分析。结果 35例UAPA患儿中,右侧21例,左侧14例;单纯性16例,合并其他心内畸形19例。超声心动图首诊27例,漏诊7例,误诊1例;诊断正确率为77.1%。UAPA超声心动图显示正常的肺动脉分叉结构消失,主肺动脉延续为一侧肺动脉,向左或向右走行,形成肺动脉左支或右支。缺如侧肺内段的肺动脉通过主动脉或其分支或其他侧支血管供血。8例患儿进行单侧肺动脉重建手术治疗后1个月超声心动图显示近端吻合口平均流速为(1.22±0.17)m/s,远端平均流速为(2.17±0.56)m/s。结论超声心动图是UAPA术前诊断的有效方法,同时也是术后评价肺动脉吻合口及肺动脉压力简便、无创、有效的方法。
[Abstract]:Objective the absence of unilateral pulmonary artery is a rare congenital pulmonary vascular abnormality. The purpose of this study was to investigate the value of echocardiography in the diagnosis and follow-up of congenital unilateral pulmonary artery deficiency in children. Data and methods retrospective analysis of medical care for women and children in Guangzhou from May 2009 to July 2016. Echocardiographic images of 35 children with UAPA confirmed by operation or CT angiography in the treatment center. Results in 35 cases of UAPA, 21 cases were right, 14 cases were left, 19 cases were simple, 19 cases were complicated with other intracardiac malformations, 27 cases were first diagnosed by echocardiography, 7 cases missed diagnosis by echocardiography, 21 cases were right side, 14 cases were left side, 19 cases were complicated with other intracardiac malformations. The diagnostic accuracy was 77.1%. UAPA echocardiography showed that the normal pulmonary artery bifurcation structure disappeared, and the main pulmonary artery continued to be one side of the pulmonary artery, going left or right. Left or right pulmonary artery. Left or right pulmonary artery with absence of medial segment of the lung. Echocardiography of proximal anastomosis 1 month after unilateral pulmonary artery reconstruction in children with pulmonary artery supply via aorta or its branches or other collateral vessels. The mean velocity of closure was 1.22 卤0.17 m / s and that of distal end was 2.17 卤0.56 m / s. Conclusion Echocardiography is an effective method for preoperative diagnosis of UAPA. It is also a simple, non-invasive and effective method for evaluating pulmonary artery anastomosis and pulmonary artery pressure.
【作者单位】：广州市妇女儿童医疗中心心脏功能诊断室;
【分类号】：R540.45;R725.4

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