超声心动图诊断三尖瓣闭锁的价值
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摘要
目的探讨超声心动图对三尖瓣闭锁(TA)的诊断价值。方法回顾性分析37例TA超声心动图二维图像、彩色多普勒声像图表现并与心脏CT、心血管造影及手术结果对比分析,总结其诊断特点,找出漏诊的原因。结果术前确诊35例,误诊2例;左位心30例,中位心2例,右位心5例;超声的特征性表现为多切面均未在三尖瓣位置看不到正常的三尖瓣叶及其活动,而是一纤维组织的增厚强光带,右心室不同程度发育不良;误诊2例为术前诊断为三尖瓣发育不良,心脏CT诊断为TA,后经手术证实;35例超声诊断与心脏CT、心血管造影及手术结果符合。结论超声心动图诊断TA具有较高的准确性。
Objective To study the value of echocardiography in diagnosis of tricuspid atresia(TA).MethodsThe two-dimensional images and color Doppler ulerasonography of TA echocardiographic in 37 cases were analyzed retrospectively,and the results were compared with those of cardiac CT,cardiac catheterization and operation.The diagnostic features of echocardiography and misdiagnosis were summarized.Results 35 cases of TA were confirmed before surgery and 2 cases were misdiagnosed.The position of heart were 30 cases with levocardia,2 cases with mesocardia and 5 cases with dextrocardia.The main echocardiographic characteristics of TA were that the normal tricuspidralue and its altivities could not be seen at the position of tricuspid valve on multiple seltions,but a thicken and strong band of a fibrous tissue.The different degree of hypoplasia of the right ventricle were exist.2 cases of TA were misdiagnosed as tricuspid valve dysplasia by ultrasound,and the cardiac CT diagnosed as TA and were confirmed by surgery.The echocardiographic characteristics of TA in 35 cases were consistent with the results of cardiac CT,cardiac angiography and operation.Conclusions Echocardiography has high accuracy in diagnosing TA.
Objective To study the value of echocardiography in diagnosis of tricuspid atresia(TA).MethodsThe two-dimensional images and color Doppler ulerasonography of TA echocardiographic in 37 cases were analyzed retrospectively,and the results were compared with those of cardiac CT,cardiac catheterization and operation.The diagnostic features of echocardiography and misdiagnosis were summarized.Results 35 cases of TA were confirmed before surgery and 2 cases were misdiagnosed.The position of heart were 30 cases with levocardia,2 cases with mesocardia and 5 cases with dextrocardia.The main echocardiographic characteristics of TA were that the normal tricuspidralue and its altivities could not be seen at the position of tricuspid valve on multiple seltions,but a thicken and strong band of a fibrous tissue.The different degree of hypoplasia of the right ventricle were exist.2 cases of TA were misdiagnosed as tricuspid valve dysplasia by ultrasound,and the cardiac CT diagnosed as TA and were confirmed by surgery.The echocardiographic characteristics of TA in 35 cases were consistent with the results of cardiac CT,cardiac angiography and operation.Conclusions Echocardiography has high accuracy in diagnosing TA.
引文
[1]卢一丹,赵博文.彩色多普勒超声心动图及心脏声学造影诊断先天性三尖瓣闭锁[J].中国超声医学杂志,2001,17(11):874-875.
[2]吴清玉主编.心脏外科学[M].济南:山东科学技术出版社,2003:491-497.
[3]郑春华,唐秀杰,王少波,等.心耳并列的超声心动图诊断价值[J].中华超声影像学杂志,2009,18(6):482-484.
[4]候传举,邓东安,石海亚,等.心脏瓣膜闭锁二维超声心动图图像特征及规律性研究[J].中国超声医学杂志,2000,16(2):121-123.
[5]金岩,邓东安,赵双,等.超声心动图对三尖瓣闭锁诊断及手术预后的评价[J].中华超声影像学杂志,2004,13(3):228-229.
[6]FEIGENBAUM H.Feigenbaum′s echocardiography.Sixth Edition[M].Philadelphia:Williams&Wilkins,2005:363-368.
[7]AHMED A A,SNODGRASS B T,KAINE S.Pulmonary atresia with intact ventricular septum and right ventricular dependent coronary circulation through the“vessels of Wearn”[J].Cardiovasc Pathol,2013,22(4):298-302.
[8]MYERS P O,BAUTISTA-HERNANDEX V,BAIRD C W,et al.Tricuspid regurgitation or Ebsteinoid dysplasia of the tricuspid valve in congenitally corrected transposition:is valvuloplasty necessary at anatomic repair[J].J Thorac Cardiovasc Surg,2014,147(2):576-580.
[2]吴清玉主编.心脏外科学[M].济南:山东科学技术出版社,2003:491-497.
[3]郑春华,唐秀杰,王少波,等.心耳并列的超声心动图诊断价值[J].中华超声影像学杂志,2009,18(6):482-484.
[4]候传举,邓东安,石海亚,等.心脏瓣膜闭锁二维超声心动图图像特征及规律性研究[J].中国超声医学杂志,2000,16(2):121-123.
[5]金岩,邓东安,赵双,等.超声心动图对三尖瓣闭锁诊断及手术预后的评价[J].中华超声影像学杂志,2004,13(3):228-229.
[6]FEIGENBAUM H.Feigenbaum′s echocardiography.Sixth Edition[M].Philadelphia:Williams&Wilkins,2005:363-368.
[7]AHMED A A,SNODGRASS B T,KAINE S.Pulmonary atresia with intact ventricular septum and right ventricular dependent coronary circulation through the“vessels of Wearn”[J].Cardiovasc Pathol,2013,22(4):298-302.
[8]MYERS P O,BAUTISTA-HERNANDEX V,BAIRD C W,et al.Tricuspid regurgitation or Ebsteinoid dysplasia of the tricuspid valve in congenitally corrected transposition:is valvuloplasty necessary at anatomic repair[J].J Thorac Cardiovasc Surg,2014,147(2):576-580.