左下肺动脉吊带的彩色多普勒超声心动图诊断价值分析

摘要

目的：探讨多普勒超声心动图对左下肺动脉吊带（ left lower-lobe pulmonary artery sling ， LLPAS）的诊断价值，分析超声心动图漏、误诊的原因，旨在提高超声对LLPAS诊断的准确性。方法回顾性分析9例经心脏CT检查及外科手术证实为LLPAS患儿的超声心动图检查资料。结果9例患儿中，1例为单纯性LLPAS，8例合并其他心血管畸形，常见的合并畸形有房间隔缺损或卵圆孔未闭6例、室间隔缺损5例、肺动脉高压4例，主动脉瓣狭窄3例，主动脉缩窄3例，动脉导管未闭2例。超声声像图特征为左上肺动脉发自肺动脉总干，左下肺动脉发自右肺动脉。9例LLPAS患儿超声心动图诊断正确6例，占66．67％；误诊、漏诊共3例，占33．33％；其中2例误诊为左肺动脉发育不良，1例漏诊。9例患者均行心脏CT检查，心脏畸形与外科手术发现均相同，诊断符合率100％；CT诊断气管狭窄3例；气管狭窄超声心动图检查均未显示。结论超声心动图可以诊断LLPAS，但容易漏误诊。%Objective To evaluate the value of Doppler echocardiography in the diagnosis of left lower -lobe pulmonary artery sling ( LLPAS) , and to analyze the misdiagnosed reason so as to improve the correct rate of diagnosis in the future .Methods Doppler echocardiography was performed and these images were compared with CT and surgical findings in 9 patients.Results In 9 cases with LLPAS, 6 cases (66.67%) were diagnosed correctly,3 cases (33.33%) were misdiagnosed.In misdiagnosed cases, 2 cases were misdiagnosed as left pulmonary artery dysplasia , 1 case was missed diagnosis.In 9 cases, 6 cases presented with artrial septal defect or patent foramen oval , 5 cases with ventricular septal defects , 4 cases with pulmonary artery hyperten-sion, 3 cases with aortic valve stenosis , 2 cases with coarctation of aorta , 2 cases with patent ductus arteriosus .Tracheobronchial stenosis was shown in 3 children.Conclusion Left lower-lobe pulmonary artery sling could be diagnosed by doppler echocardio-graphy , but it was prone to be misdiagnosed .