摘要
目的探寻完全性大动脉转位(TGA)超声心动图(ECG)图像特征及规律性。方法应用ECG检查110例TGA,所有病例均经心血管造影或(和)手术证实。结果根据ECG图像特征对104例做出正确诊断,诊断准确率为94.5%,5例误诊右心室双出口,1例误诊单心室。TGA的ECG图像特征及规律性明显:①二维超声心动图(2DE)胸骨旁左室长轴切面显示主动脉在前方发自右心室,肺动脉在后方发自左心室。②2DE胸骨旁大动脉短轴切面显示两条大动脉呈两个环状回声,称2DE“双环征”,根据两环相互位置关系判断转位的类型并根据两环内径鉴别肺动脉狭窄(PS)和肺动脉高压(PH)。③合并室间隔缺损的TGA多见,室间隔完整的TGA少见。后者均与房间隔缺损(ASD)和动脉导管未闭(PDA)并存。④在临床上有室间隔缺损的TGA合并PS患者存活时间较长;合并PH患者生存时间明显缩短。室间隔完整的TGA患儿,生存时间长短与ASD和PDA的直径大小有关,缺损直径越大患儿生存时间相对较长。结论TGA的ECG图像特征及规律性明显,ECG对TGA有特异性诊断价值,对新生儿TGA完全可以取代有创的心血管造影检查。
Objective To probe into the imaging characteristics and regularity of complete transposition of the great arteries （TGA） in echocardiography （ECG）. Methods One hundred and ten patients of TGA were examined with ECG, all cases were confirmed by angiocardiography and/or operation. Results One hundred and four cases of TGA were properly diagnosed based on the ECG characteristics with diagnosis accuracy 94.5%. 5 cases were misdiagnosed as double-outlet right ventricle and 1 case as single ventricle. The ECG characteristic and regularity of TGA were obvious： （1）The anterior aorta coming from right ventricle and the posterior pulmonary artery coming from left ventricle could be seen from parastemal left ventricle long axis view of 2DE. （2）Parastemal short axis view of 2DE showed bi-cycling echo, the 2DE ＂Bi-cycling Sign＂. Judgement of the type of TGA could base on the location relationship of the two circles and pulmonary stenosis（PS） and pulmonary hypertension （PH） can be distinguished after comparing the diameters of the two circles. （3）Concurrence of TGA with ventriclar septal defect was common and TGA with intact interventricular septum was rare. The latter must be associated with atrial septal defect （ASD） and patent ductus arteriosus （PDA）. （4）Patients with TGA and concomitant ventriclar septal defect could survive longer when live with PS, but shorter with PH. The survive time of TGA patients with intact interventricular septum depended on the size of ASD and PDA. The bigger the size of ASD and PDA, the longer their survive time. Conclusion ECG showed obvious image features and regularities for TGA and has specific value for its diagnosis. For neonates, ECG can completely take the place of invasive angiocardiography.
出处
《中国心血管病研究》
CAS
2006年第10期735-737,共3页
Chinese Journal of Cardiovascular Research
关键词
心脏缺损
先天性
大血管错位
超声心动描记术
Heart difects, congential
Transposition of great vessels
Echocardiography
