CAJ | 학술논문

目的：探讨彩色多普勒超声心动图顺序分段分析法对矫正型大动脉转位（CTGA）的诊断价值。方法对11例 CTGA 患者采用彩色多普勒超声心动图顺序分段分析法判定心脏位置、连接关系及心内结构、功能和血流信号的变化。结果11例 CTGA 患者中，彩色多普勒超声心动图顺序分段分析法对 CTGA 的诊断符合率达100．0％（11/11）。SLL 型（心脏位置正常）9例（81．8％），IDD 型（镜面右位心）2例（18．1％）。SLL 型合并室间隔缺损9例、合并肺动脉狭窄7例和合并解剖三尖瓣中度反流8例；合并房间隔缺损4例，其中 SLL 型3例，IDD 型1例；IDD 型合并室间隔缺损、肺动脉狭窄和解剖三尖瓣中度反流1例。均经手术证实。结论CTGA 的超声表现错综复杂，心房与心室连接不一致和心室与大动脉连接不一致是诊断 CTGA 的关键，运用其特征性能有效提高诊断符合率，部分替代心血管造影等检查，为心胸外科提供重要的诊断依据。
목적：탐토채색다보륵초성심동도순서분단분석법대교정형대동맥전위（CTGA）적진단개치。방법대11례 CTGA 환자채용채색다보륵초성심동도순서분단분석법판정심장위치、련접관계급심내결구、공능화혈류신호적변화。결과11례 CTGA 환자중，채색다보륵초성심동도순서분단분석법대 CTGA 적진단부합솔체100．0％（11/11）。SLL 형（심장위치정상）9례（81．8％），IDD 형（경면우위심）2례（18．1％）。SLL 형합병실간격결손9례、합병폐동맥협착7례화합병해부삼첨판중도반류8례；합병방간격결손4례，기중 SLL 형3례，IDD 형1례；IDD 형합병실간격결손、폐동맥협착화해부삼첨판중도반류1례。균경수술증실。결론CTGA 적초성표현착종복잡，심방여심실련접불일치화심실여대동맥련접불일치시진단 CTGA 적관건，운용기특정성능유효제고진단부합솔，부분체대심혈관조영등검사，위심흉외과제공중요적진단의거。
Objective To evaluate the value of sequential color Doppler echocardiography (CDE)segmentation analysis in the diagnosis of corrected transposition of great arteries(CT-GA).Methods Sequential CDE segmentation analysis was used to determine heart position,con-nection relation,intracardiac structure,heart function and blood flow signal changes in 11 patients with CTGA.Results The diagnostic accordance rate of sequential CDE segmentation analysis was 100.0% (11/11 ).Among the 11 patients,SLL transposition (normal heart position)was found in 9(81.8%),and IDD transposition(mirror-image dextrocardia)in 2(18.1%).In addition, SLL transposition was complicated by ventricular septal defect in 9 patients,by pulmonary steno-sis in 7,and by moderate anatomical tricuspid regurgitation in 8.Among the 4 CTGA patients with atrial septal defect,SLL transposition was found in 3 and IDD transposition in 1.Further-more,IDD transposition was complicated by ventricular septal defect,pulmonary stenosis and moderate anatomical tricuspid regurgitation in 1 patient.All cases were confirmed by surgery. Conclusion Ultrasonography findings of CTGA are complex.Inconsistent connections between a-trium and ventricle as well as between ventricle and artery are the key to the diagnosis of CTGA. Sequential CDE segmentation analysis can effectively improve diagnostic accordance rate,partly replace cardiovascular imaging and provide an important basis for the diagnosis of cardiothoracic diseases.