Diagnostic value of ultrasound for supracardiac anomalous pulmonary venous connection and causes of missed diagnosis and misdiagnosis analysis

ZHAO Ni; ZHOU Jieli; ZHANG Shiqian; HU Yun

doi:10.16245/j.cnki.issn1008-6978.2020.06.020

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Diagnostic value of ultrasound for supracardiac anomalous pulmonary venous connection and causes of missed diagnosis and misdiagnosis analysis

更新时间：2021-10-08

- Diagnostic value of ultrasound for supracardiac anomalous pulmonary venous connection and causes of missed diagnosis and misdiagnosis analysis
- Journal of Clinical Ultrasound in Medicine Vol. 22, Issue 6, Pages: 462-465(2020)
- 作者机构：
  
  空军军医大学第一附属医院超声科
- 作者简介：
- 基金信息：
- DOI：10.16245/j.cnki.issn1008-6978.2020.06.020
  CLC： R445.1;R543.2
- Published：2020，
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[1]赵妮,周洁丽,张诗倩,胡运.超声对心上型肺静脉异位引流的诊断价值及其漏误诊原因分析[J].临床超声医学杂志,2020,22(06):462-465.

ZHAO Ni, ZHOU Jieli, ZHANG Shiqian, et al. Diagnostic value of ultrasound for supracardiac anomalous pulmonary venous connection and causes of missed diagnosis and misdiagnosis analysis. [J]. Journal of Clinical Ultrasound in Medicine 22(6):462-465(2020)
[1]赵妮,周洁丽,张诗倩,胡运.超声对心上型肺静脉异位引流的诊断价值及其漏误诊原因分析[J].临床超声医学杂志,2020,22(06):462-465. DOI： 10.16245/j.cnki.issn1008-6978.2020.06.020.

ZHAO Ni, ZHOU Jieli, ZHANG Shiqian, et al. Diagnostic value of ultrasound for supracardiac anomalous pulmonary venous connection and causes of missed diagnosis and misdiagnosis analysis. [J]. Journal of Clinical Ultrasound in Medicine 22(6):462-465(2020) DOI： 10.16245/j.cnki.issn1008-6978.2020.06.020.

摘要

目的探讨超声对心上型完全性和部分性心上型肺静脉异位引流（TAPVC、PAPVC）的诊断价值

并分析其漏误诊原因。方法回顾性分析204例TAPVC、98例PAPVC患者的彩色多普勒超声图像特征

并与CT或手术对照

分析超声诊断的准确率及合并的畸形。结果 204例心上型TAPVC

超声诊断准确率为100%

其中193例汇入头臂静脉

11例直接开口于右上腔静脉;202例显示完整4支肺静脉

仅2例显示3支肺静脉;主要合并的畸形有房间隔缺损165例（80.9%）、卵圆孔未闭34例（16.7%）。98例PAPVC

诊断准确率75.5%（74/98）

其中60例引流入头臂静脉

37例汇入右上腔静脉

1例经奇静脉汇入上腔静脉;单支71例

两支21例

三支6例;合并的常见畸形有房间隔缺损67例（68.4%）、卵圆孔未闭15例（15.3%）;误诊11例（11.2%）

漏诊13例（13.3%）

包含引流支数漏判9例和诊断漏判4例。结论超声对PAPVC的诊断准确率不及TAPVC。通过全面扫差异常血管走行

加强伪像及正常或异常心内结构的鉴别诊断有助于降低漏误诊率。

Abstract

ObjectiveTo explore the diagnostic value of ultrasound for supraventricular total and partial pulmonaryvenous connection（TAPVC

PAPVC）

and analyze the causes of misdiagnosis and missed diagnosis.MethodsThe characteristicsof color Doppler ultrasonography on 204 cases with TAPVC and 98 cases with PAPVC were retrospectively analyzed

theaccuracy of diagnosis and the combined malformations were analyzed by compared with CT or surgery.ResultsThe accuracy ofultrasound diagnosis of 204 TAPVC cases was 100%. 193 cases were transferred to the brachiocephalic vein

11 cases weredirectly open to the right superior vena cava.202 patients showed complete pulmonary veins

only 2 patients showed 3 pulmonaryveins.Combined malformations included 165 cases（80.9%）of atrial septal defect

34 cases（16.7%）of patent foramen ovale.Among 98 cases of PAPVC

the accuracy of ultrasound diagnosis was 75.5%（74/98）. 60 cases were introduced into thebrachiocephalic vein

37 cases were directly transferred into the right superior vena cava

and 1 case was transferred into thesuperior vena cava via azymatic vein.There were 71 cases of single

21 cases of two

and 6 cases of three.Combined malformationsincluded 67 cases（68.4%）of atrial septal defect

15 cases（15.3%）of patent foramen ovale.11 cases were misdiagnosed and13 cases were missed diagnosed

including 9 cases of missed judgment of drainage count and 4 cases of missed diagnosisof diagnosis.ConclusionThe accuracy of ultrasound in the diagnosis of PAPVC is weaker than that of TAPVC. Bycomprehensively scanning abnormal blood vessel contours and enhancing the differential diagnosis of artifacts and normal orabnormal intracardiac structures

it can help to reduce the rate of missed diagnosis.

关键词

超声心动描记术肺静脉异位引流心上型完全性部分性漏误诊

Keywords

EchocardiographyAnomalous pulmonary venous connectionsupracardiacTotalpartialMissed diagnosis and misdiagnosis

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