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目的探讨多普勒超声心动图对心耳并列的诊断价值。方法选取北京安贞医院2007年5月~2016年5月收治的心耳并列患儿16例,应用VIVID7彩色多普勒超声心动图仪行超声心动图检查,并进行MRI、心血管造影检查或外科手术病理分析,最后明确诊断。结果 16例患儿均为右心耳左侧并列合并复杂的先天性心血管畸形,其中6例患儿合并右室双出口,4例患儿合并肺动脉闭锁,4例患儿合并完全性大动脉转位,2例患儿合并三尖瓣发育不良趋闭锁并肺动脉狭窄,分别占总数的37.5%、25.0%、25.0%及12.5%;12例患儿为剑突下两房观,10例患儿为左心室长轴观,10例患儿为胸骨旁大动脉短轴观,8例患儿为胸骨旁四腔观,分别占总数的75.0%、62.5%、62.5%及50.0%;10例患儿经超声心动图检查明确诊断,4例患儿无法确诊,2例患儿漏诊,分别占总数的62.5%、25.0%及12.5%。MRI、心血管造影检查后再对患者进行超声心动图检查,14例患儿明确诊断,2例患儿仍然无法确诊,这是因为只显示异常走形的房间隔,没有良好显示心耳,分别占总数的87.5%及12.5%。结论多普勒超声心动图对心耳并列具有较高的诊断价值,值得在临床推广。
Objective To explore the value of Doppler echocardiography in the diagnosis of atrial appendage. Methods A total of 16 children with atrial appendage were selected from Anzhen Hospital of Beijing from May 2007 to May 2016. Echocardiography was performed with VIVID7 color Doppler echocardiography, and MRI, cardiovascular angiography or surgery Surgical pathology, the final diagnosis. Results All the 16 children were complicated with congenital cardiovascular malformation by the left side of right atrial appendage. Among them, 6 cases had right ventricular double outlet, 4 cases had pulmonary atresia, 4 cases had complete aortic transposition , Two cases of tricuspid regurgitation and pulmonary stenosis, which accounted for 37.5%, 25.0%, 25.0% and 12.5% of the total respectively. Twelve cases were two rooms with xiphoid view and ten cases were The left ventricular long axis view, 10 cases of children with parasternal aortic short axis view, 8 cases of children with parasternal four-chamber view, respectively, the total number of 75.0%, 62.5%, 62.5% and 50.0%; 10 cases of children Echocardiography confirmed diagnosis, 4 cases of children can not be diagnosed, 2 cases of missed diagnosis of children, respectively, the total number of 62.5%, 25.0% and 12.5%. Echocardiography was performed on MRI and cardiovascular angiography. 14 cases were diagnosed correctly and 2 cases were still unable to be diagnosed. This is because only the abnormally shaped atrial septum is shown, and the atrial appendage is not well displayed, accounting for 87.5% and 12.5% of the total. Conclusions Doppler echocardiography has a high diagnostic value in the atrial appendage and is worthy of clinical application.