摘要
目的观察超声心动图对先天性右位心合并复杂心血管畸形的诊断价值。方法以心血管造影结果为对照,应用超声心动图按节段分析法评价63例先天性右位心合并复杂心血管畸形患儿的心脏解剖结构。结果63例右位心患儿中镜像心28例,右旋心35例。超声心动图和心血管造影对心脏各节段诊断特异性有高度一致性,两方法相比较差异有统计学意义(P>0.05)。超声心动图对心房方位、心室形态、房室连接、心室动脉连接及主动脉位置诊断准确率均大于90%。镜像心大多各节段连接一致,可合并房间隔缺损、室间隔缺损等简单畸形(42.9%),也存在合并肺动脉狭窄的复杂心血管畸形(50%),主要为法洛四联症、右室双出口、单心室;右旋心大多各节段连接不一致,多合并肺动脉狭窄或闭锁的复杂畸形(88.6%)如单心室、右室双出口、大动脉转位、肺动脉闭锁等。结论超声心动图对先天性右位心合并复杂心血管畸形患儿大多能做出明确诊断,可作为右位心诊断的首选或筛选方法。
Objective Our goal was to evaluate the value of echocardiography in diagnosing congenital dextrocardia with complex cardiovascular anomalies. Methods We enrolled 63 patients with congenital dextrocardia with complex cardiovascular anomalies and detected the anatomic structure of heart according to segmental approach by echocardiography compared with angiography.Results Of total 63 patients,28 cases had mirror-image dextrocardia,35 cases had dextroversion. There was high consistency and no significant difference in diagnosing dextrocardia with complex anomalies between echocardiography and angiography （ P 〉 0. 05 ）, the specificity of transthoracic echocardiography in diagnosing the atrial, situs, ventricular structure, the connection of the ventricle and arteries or auricle, arterial situs was more than 90%. In mirror-image dextrocardia, majority had concordant segmental connection and could present anomalies with simple anomalies （42.9%） including atrial septal defect and ventricular septal defect, in addition, the major complex anomalies such as pulmonary stcnosis were tetralogy of Fallot, double outlet of right ventricle （50%）;In dextroversion, majority had discordant segmental connection and mostly presented anomalies with pulmonary stenosis or pulmonary atresia, including single ventricle, double outlet of fight ventricle, transposition of great arteries,pulmonary atresia and so on（88.6%）. Conclusion Echoca rdiography can exactly diagnose the most congenital dextrocardia with complex cardiovascular anomalies, and can be the first or alternative screening choice for diagnosing dextrocardia.
出处
《国际儿科学杂志》
2007年第4期242-244,共3页
International Journal of Pediatrics
