摘要
目的观察超声心动图用于术前诊断儿童埃布斯坦畸形(EA)及选择术式的价值。方法回顾性分析216例EA患儿的超声心动图资料,测算三尖瓣隔瓣附着点上缘与二尖瓣前瓣附着点下缘之间距离(MTD)、二尖瓣前瓣根部与心尖距离和三尖瓣隔瓣根部与心尖距离的比值(MTR)及扩展格拉斯哥预后(GOSE)评分;对比MTD及MTR诊断儿童EA的准确率,分析GOSE评分对于选择术式的价值。结果216例中,199例超声心动图见三尖瓣隔瓣下移;根据MTD>15 mm、MTR>1.2及MTR>1.5诊断儿童EA的准确率分别为81.91%(163/199)、95.98%(191/199)及68.34%(136/199),差异均有统计学意义(χ^(2)=9.802~51.856;P均<0.001)。178例接受手术治疗,其中101例接受双心室修补术,90例GOSE评分≤1.00者术后均恢复良好,GOSE评分>1.00的11例中,5例(5/11,45.45%)术后发生不良事件;62例接受“一个半”心室修补术,GOSE评分≤1.00者22例、>1.00者40例,术后均恢复良好;15例接受单心室修补术,GOSE评分均>1.00,术后均恢复良好。结论根据术前超声心动图所测MTR>1.2可较准确地诊断儿童EA;GOSE评分有助于选择术式。
Objective To explore the value of echocardiography for preoperative diagnosis and surgical planning of Ebstein anomaly(EA)in children.Methods Echocardiography data of 216 EA children were retrospectively analyzed.The mitral valve-tricuspid valve distance(MTD),the ratio of distance from the root of anterior mitral leaflets to cardiac apex and distance from the root of the tricuspid valve septal leaflets to cardiac apex(MTR)were measured,and Glasgow outcome scale extended(GOSE)scores were calculated.The accuracy of MTD and MTR for diagnosing EA in children were compared,and the value of GOSE for surgical planning of EA was analyzed.Results Among 216 cases,descending tricuspid valve septum was observed with echocardiography in 199 cases.The accuracy of MTD>15 mm,MTR>1.2 and MTR>1.5 for diagnosing EA in children was 81.91%(163/199),95.98%(191/199)and 68.34%(136/199),respectively,being significantly different(χ^(2)=9.802—51.856,all P<0.001).Among 178 cases who underwent surgical operations,biventricular repair was performed in 101 cases,among them 90 cases with GOSE score≤1.00 recovered well after operation,while adverse events occurred in 5 cases among 11 cases(5/11,45.45%)with GOSE score>1.00.One-and-a-half ventricle repair was performed in 62 cases who covered well after operation,including 22 cases with GOSE score≤1.00 and 40 cases>1.00.Single-ventricular repair was performed in 15 cases with GOSE score>1.00,and the patients recovered well after operation.Conclusion Preoperative echocardiography measured MTR>1.2 was relatively reliable for accurately diagnosing EA in children.GOSE score was helpful for surgical planning.
作者
赵雷生
张玉奇
陈丽君
张志芳
ZHAO Leisheng;ZHANG Yuqi;CHEN Lijun;ZHANG Zhifang(Department of Pediatric Cardiology,Shanghai Children's Medical Center,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China)
出处
《中国医学影像技术》
CSCD
北大核心
2024年第7期964-967,共4页
Chinese Journal of Medical Imaging Technology
基金
国家自然科学基金(82001835)。
关键词
埃布斯坦畸形
三尖瓣
超声检查
Ebstein anomaly
tricuspid valve
ultrasonography
