Horiguchi Y, Hiraishi S, Misawa H, Agata Y, Nakae S
Department of Paediatrics, Kitasato University, School of Medicine, Kanagawa, Japan.
Br Heart J. 1992 Apr;67(4):312-5. doi: 10.1136/hrt.67.4.312.
Shunt vessels were imaged and shunt flow was analysed by cross sectional and Doppler echocardiography in 12 patients who had had 14 shunt procedures (nine left Blalock-Taussig shunts, three right Blalock-Taussig shunts, one modified Waterston shunt, and one central shunt).
The shunt vessels were classified by echocardiography as uniformly patent, segmentally stenosed, and uniformly stenosed. These findings were compared with those of angiography. Also the peak flow velocities at the aortic and the pulmonary ends of the shunt vessels were measured by Doppler echocardiography and the ratio of these values was calculated for each shunt.
Twelve (85.7%) of 14 shunt vessels were imaged along their entire length by cross sectional echocardiography. The two remaining shunt vessels were only partially imaged. In 10 patients who also had angiography the echocardiographic and angiographic images of the shunt vessels were identical. The ratio of the peak flow velocity measured at the aortic and the pulmonary ends of the shunt vessel was significantly larger in the segmentally stenosed shunt vessels than in the uniformly patent shunt vessels (p < 0.001). The ratio in the two shunt vessels only partially imaged by cross sectional echocardiography indicated that they were segmentally stenosed.
The combination of cross sectional and Doppler echocardiography may be useful for determining either the patency or the morphology of an aortopulmonary shunt.
对12例接受过14次分流手术（9例左侧Blalock-Taussig分流术、3例右侧Blalock-Taussig分流术、1例改良Waterston分流术和1例中心分流术）的患者，通过横断面和多普勒超声心动图对分流血管进行成像并分析分流血流。
通过超声心动图将分流血管分为全程通畅、节段性狭窄和全程狭窄。将这些结果与血管造影结果进行比较。同时，用多普勒超声心动图测量分流血管主动脉端和肺动脉端的峰值流速，并计算每个分流的这些值的比值。
14条分流血管中有12条（85.7%）通过横断面超声心动图显示了其全长。其余2条分流血管仅部分显影。在10例也进行了血管造影的患者中，分流血管的超声心动图和血管造影图像一致。节段性狭窄的分流血管中，分流血管主动脉端和肺动脉端测得的峰值流速比值显著高于全程通畅的分流血管（p<0.001）。横断面超声心动图仅部分显影的2条分流血管的比值表明它们存在节段性狭窄。
横断面和多普勒超声心动图相结合可能有助于确定主肺动脉分流的通畅情况或形态。
