| 摘要: |
| 目的总结左冠状动脉异常起源于肺动脉（ALCAPA）的经胸超声心动图（TTE）特征及诊断思路。方法 回顾性分析我院经手术证实的8例ALCAPA患者的临床及影像学资料，总结其TTE特征。结果8例ALCAPA患者左室收缩功能均正常，其中婴儿型1例，早期出现肺炎、ST改变和心影增大；成人型7例，多无明显症状，因发现心脏杂音首次就诊。8例患者首诊超声仅确诊1例，高年资医师复诊检查确诊6例，1例误诊冠状动脉-肺动脉瘘。ALCAPA的典型TTE特征表现为左室增大，右冠状动脉增宽，心肌侧支血流丰富，肺动脉内见来自左冠状动脉的异常血流信号。结论 婴儿期发现心力衰竭、ST改变、心影增大；儿童或成人期发现冠状动脉侧支血流丰富、右冠状动脉增宽，均需警惕ALCAPA，应仔细扫查左冠状动脉的起源和血流方向，有助于提高TTE对ALCAPA的早期诊断。 |
| 关键词: 超声心动描记术 先天性心脏病 左冠状动脉异常起源于肺动脉 |
| DOI： |
| 投稿时间：2021-03-26修订日期：2021-09-03 |
| 基金项目:陆军军医大学第二附属医院军事临床医学创新技术项目 |
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| Transthoracic echocardiography in diagnosing anomalous left coronary artery from the pulmonary artery |
| ouyangna,lixiaoyu,lipeijing,zuohao,raorongsheng,gaoyunhua,xiahongmei |
| () |
| Abstract: |
| ObjectiveTo Summarize the features and diagnostic thinking of anomalous origin of left coronary artery from pulmonary artery（ALCAPA） with transthoracic echocardiography（TTE）.MethodsThe clinical and imaging features of 8 ALCAPA patients confirmed by surgery in our hospital were retrospectively analyzed,and the characteristics of TTE were summarized.ResultsAmong the 8 cases of ALCAPA，the left ventricular systolic function was all normal, 1 case was infant type with pneumonia，ST changes and enlarged heart shadow in the early stage.7 cases were adult type with no obvious symptoms，and the heart murmur was found in the first visit.Only 1 case was first diagnosed by ultrasound，6 cases were diagnosed after re-examination by senior doctors，1 case was misdiagnosed as coronary pulmonary artery fistula. Typical TTE characteristics of ALCAPA: enlarged left ventricle，widened right coronary artery，abundant collateral blood flow，abnormal blood flow signal in pulmonary artery.Conclusion Bothinfants with heart failure and ST changes and enlarged heart shadows and children or adults with abundant collateral blood flow and widened right coronary arteries all need to be alert to ALCAPA.Careful scanning of the origin and blood flow direction of the left coronary artery（LCA） can help improve the early diagnosis of ALCAPA by TTE. |
| Key words: Echocardiography Congenital heart disease Anomalous left coronary artery from the pulmonary artery |
