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目的探讨超声心动图诊断先天性冠状动脉畸形的意义。方法对本院诊治的40例先天性冠状动脉畸形的超声心动图结果与心血管造影、手术结果进行分析比较。结果冠状动脉起源于肺动脉12例占30%;冠状动脉起源于主动脉窦8例占20%;冠状动脉瘘20例占50%,累及右冠状动脉12例(60%)。其中多个瘘口1例,累及左冠状动脉8例(占40%)。瘘入右心腔13例(占65%),瘘入肺动脉5例(占25%),瘘入左心腔2例(占10%)。超声心动图敏感性92%,特异性100%。对冠状动脉起源于肺动脉1例误诊为心内膜弹力纤维增生症,1例左冠状动脉起源于右冠窦漏诊。结论超声心动图对先天性冠状动脉畸形有较高的诊断价值。可作为首选诊断方法。对先天性患儿应仔细探测左右冠状动脉及分支,并结合其它临床资料进行分析。
Objective To investigate the significance of echocardiography in the diagnosis of congenital coronary artery disease. Methods 40 cases of congenital coronary artery disease diagnosis and treatment in our hospital echocardiography results and cardiovascular angiography, surgical results were analyzed and compared. Results Coronary artery originated from pulmonary artery in 12 cases, accounting for 30%. Coronary artery originated from aortic sinus in 20%, coronary fistula in 50, and right coronary artery in 12 (60%). One case of multiple fistula, involving the left coronary artery in 8 cases (40%). Fistula into the right heart chamber in 13 cases (65%), fistula into the pulmonary artery in 5 cases (25%), fistula into the left heart chamber in 2 cases (10%). Echocardiography 92% sensitivity, specificity 100%. A case of coronary artery originated in the pulmonary artery misdiagnosed as endocardial fibroelastosis, a case of left coronary artery originated in the right coronary sinus missed diagnosis. Conclusion Echocardiography has high diagnostic value of congenital coronary artery deformity. Can be used as the preferred method of diagnosis. The congenital children should be carefully detected around the coronary artery and branches, combined with other clinical data for analysis.