摘要
目的探讨弯刀综合征(scimitar syndrome)经胸超声心动图(transthoracic echocardiography,TTE)的图像特征及漏诊原因,提高TTE诊断的准确性。方法选取经外科手术证实54例弯刀综合征患儿的超声图像。结果54例弯刀综合征中,心脏右移27例,右肺动脉发育不良19例;右侧两支肺静脉异位引流40例,单支右下肺静脉异位引流13例,肺静脉支数变异1例。合并房间隔缺损38例、动脉导管未闭11例、室间隔缺损8例、法洛四联症2例、主动脉缩窄2例、单心室2例、右室双出口1例。TTE确诊36例,诊断正确率66.7%;漏诊肺静脉异位连接18例,漏诊率33.3%。结论TTE可以诊断弯刀综合征,但容易漏误诊;加强剑突下、高位胸骨旁切面肺静脉的探查,可提高经胸超声心动图对弯刀综合征的诊断正确率。
Objective To analyze the characteristic imagines and missed-diagnostic reasons of Scimitar syndrome so as to improve the diagnostic accuracy of transthoracic echocardiography.Methods Echocardiographic images of 54 cases of Scimitar syndrome confirmed by surgical procedures were retrospectively analyzed.Results In 54 cases with Scimitar syndrome,there were 27 cases with dextroposition,19 cases with hypoplasia of right pulmonary artery.40 cases with anomalous drainage of two right pulmonary veins,13 cases with anomalous drainage of single right inferior pulmonary vein,and 1 case with variation in the number of pulmonary veins.The common associated anomalies included 38 cases with atrial septal defects,11 cases with patent ductus arteriosus,8 cases with ventricular septal defects,2 cases with tetralogy of Fallot,2 cases with coarctation of aorta,2 cases with single ventricles,1 case with double outlet right ventricle.In 54 cases,36 cases(66.7%)were diagnosed correctly,18 cases(33.3%)with anomalous connection of pulmonary vein were miss diagnosed.Conclusion Scimitar syndrome could be diagnosed by transthoracic echocardiography,but it is prone to be miss diagnosed.The diagnostic accuracy of transthoracic echocardiography for scimitar syndrome could be improved by strengthening the exploration of pulmonary veins in subxiphoid and high parasternal views.
作者
周春霞
张玉奇
陈丽君
吴兰平
洪雯静
ZHOU Chunxia;ZHANG Yuqi;CHEN Lijun;WU Lanping;HONG Wenjing(Department of Thoracic Surgery,Shanghai Children’s Medical Center,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China;Department of Cardiology,Shanghai Children’s Medical Center,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China)
出处
《医学影像学杂志》
2022年第11期1892-1896,共5页
Journal of Medical Imaging
基金
国家自然科学基金项目(编号:82001835)
小儿心血管(上海市卫计委高端儿科海外研修团队)基金项目(编号:GDEK201706)
上海交通大学“交大之星”计划医工交叉研究基金项目(编号:YG2019QNB03)。
关键词
弯刀综合征
先天性心脏病
超声心动图
Scimitar syndrome
Congenital heart disease
Echocardiography
