先天性二尖瓣瓣上环的超声心动图诊断价值及漏误诊分析

发布时间：2018-07-16 07:43

【摘要】：目的分析先天性二尖瓣瓣上环(CSMR)彩色多普勒超声心动图图像特征,评价超声心动图对CSMR的诊断价值,分析漏、误诊的原因,提高超声心动图技术对CSMR诊断的准确性。资料与方法选择经心外科手术明确为CSMR的66例患儿为研究对象,对其超声心动图检查结果及手术效果进行回顾性分析。结果 66例患儿中,超声诊断符合52例(78.79%);超声漏、误诊14例(21.21%),其中12例术前超声心动图漏诊CSMR,2例术前误诊为三房心。66例患者均合并其他心血管系统畸形,最常见的合并畸形有肺动脉高压、二尖瓣狭窄、室间隔缺损、主动脉缩窄等。53例患者行CSMR切除术,手术前CSMR处最大峰值压差(21.29±10.58)mm Hg,手术后(13.02±5.78)mm Hg,差异有统计学意义(P0.01)。结论超声心动图技术可以诊断先天性CSMR,但容易漏诊;CSMR外科手术效果良好,但需要注意二尖瓣功能。
[Abstract]:Objective to analyze the characteristics of color Doppler echocardiography in congenital superior mitral annulus (CSMR), to evaluate the diagnostic value of echocardiography in CSMR, to analyze the causes of leakage and misdiagnosis, and to improve the accuracy of echocardiography in the diagnosis of CSMR. Materials and methods 66 children with CSMR who underwent cardiac surgery were selected as subjects. The results of echocardiography and the results of operation were analyzed retrospectively. Results among 66 cases, 52 cases (78.79%) were diagnosed by ultrasonography, 14 cases (21.21%) were misdiagnosed by ultrasonography leakage, 2 cases (2 cases) were misdiagnosed by echocardiography before operation, 2 cases were misdiagnosed as tricuspid heart, 66 cases were misdiagnosed with other cardiovascular system malformations, 12 cases (21.21%) were misdiagnosed by echocardiography before operation. The most common complications were pulmonary hypertension, mitral stenosis, ventricular septal defect and coarctation of aorta. CSMR was performed in 53 patients. The maximum peak pressure difference at CSMR was (21.29 卤10.58) mm Hg before operation, and (13.02 卤5.78) mm Hg after operation (P0.01). Conclusion Echocardiography can be used to diagnose congenital CSMRs, but it is easy to miss the diagnosis of CSMR surgery, but it is necessary to pay attention to mitral valve function.
【作者单位】：南京医科大学附属南京儿童医院超声科;上海交通大学医学院附属上海儿童医学中心心内科;
【分类号】：R725.4;R540.45

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