| 李璐韦,张静,钟家蓉,白永虹,计晓娟,何玲.单侧肺动脉起源于升主动脉的超声诊断与预后[J].中国医学影像技术,2015,31(4):550~553 |
| 单侧肺动脉起源于升主动脉的超声诊断与预后 |
| Echocardiography diagnosis and prognosis of the anomalous origin of one pulmonary artery from the ascending aorta |
| 投稿时间：2014-11-13 修订日期：2015-02-12 |
| DOI：10.13929/j.1003-3289.2015.04.018 |
| 中文关键词: 单侧肺动脉起源异常 超声心动描记术 肺动脉高压 预后 |
| 英文关键词:Anomalous origin of one pulmonary artery Echocardiography Pulmonary arterial hypertension Prognosis |
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| 中文摘要: |
| 目的 探讨单侧肺动脉异常起源于升主动脉(AOPA)的早期超声诊断及预后评估。方法 回顾性分析12例经手术确诊的AOPA患儿的影像学资料、治疗及随访情况。结果 12例患者均为右肺动脉起源于升主动脉(AORPA),均合并其他心脏畸形,其中以合并动脉导管未闭最多见(8/12,66.67%)。术前超声心动图确诊10例,诊断符合率83.33%(10/12)。术前超声心动图证实肺动脉高压者11例(11/12,93.67%),平均肺动脉压(79.45±14.36)mmHg术后1周平均肺动脉压(35.91±16.26)mmHg,手术前后平均肺动脉压差异有统计学意义(Z=3.936,P=0.003);术前9例重度肺动脉高压者中,术后正常5例,中度3例,轻度1例;术前2例中度者中,术后正常1例,轻度1例。无肺动脉高压的1例患儿合并法洛四联症。术后成功随访8例,随访时间1~50个月,肺动脉压力均恢复正常。随访期间无再次手术病例。结论 在AOPA的临床诊断中,超声心动图如联合多层螺旋CT心血管CTA检查,可能替代心导管造影这一有创性检查。早期诊断并治疗AOPA,预后良好。 |
| 英文摘要: |
| Objective To explore the early diagnosis and prognosis of the anomalous origin of one pulmonary artery from the ascending aorta (AOPA). Methods Totally 12 patients with AOPA confirmed by surgery were analyzed retrospectively, including the data of imaging, treatment and follow-up. Results All of 12 patients had the anomalous origin of the right pulmonary artery from the ascending aorta (AORPA). In addition, other cardiac malformations were found in all the patients and the most common one was patent ductus arteriosus (PDA, 8/12, 66.67%). The accuracy of echocardiography in diagnosis of AOPA was 83.33% (10/12). A total of 11 patients with pulmonary arterial hypertension (PAH)(11/12, 93.67%) were found by echocardiography, and mean pulmonary artery pressure (MPAP) was (79.45±14.36)mmHg, and then the MPAP had descended to (35.91±16.26)mmHg one week after operation. There was significant difference between preoperation and postoperation for the MPAP (Z=3.936, P=0.003). After operation, 5 cases were normal, 3 cases were moderate PAH, and 1 case had mild PAH among 9 server PAH cases before operation. Among 2 moderate PAH patients pre-operation, one patient was normal and another had mild PAH post-operation. Only one patient with tetralogy of Fallot had no PAH. Eight patients who were followed up ranging from 1 to 50 months had normal pulmonary artery pressure (PAP) monitoring by echocardiography. There were no reoperation cases during the follow-up period. Conclusion Echocardiography with multi-layers CT may replace the invasive cardiovascular angiography in the diagnosis of AOPA. The prognosis of AOPA will be better if treated earlier. |
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