Gnanapragasam J P, Houston A B, Doig W B, Fraser R, Lilley S, Murtagh E, Olafsson G
Department of Cardiology, Royal Hospital for Sick Children, Glasgow.
Br Heart J. 1991 Sep;66(3):238-43. doi: 10.1136/hrt.66.3.238.
To evaluate the additional information provided by colour Doppler in the ultrasonic assessment of congenital heart disease.
A prospective study of 215 children (age range 1 day-16 years) presenting with clinical signs of congenital heart disease.
Colour Doppler was essential for the diagnosis of an anomalous left coronary artery and altered the management of a patient initially diagnosed as having cardiomyopathy. Colour Doppler provided extra information, but without major impact on management, in the following: the diagnosis of ventricular septal defects associated with other defects, of multiple ventricular septal defects, of anomalous pulmonary venous drainage, and of mild mitral regurgitation; the demonstration of site of coarctation, of stenotic or hypoplastic pulmonary artery branches, of unobstructed flow through a right atrial membrane, and of left ventricle to right atrium regurgitation; the assessment of the width of the duct and of flow through the patent foramen ovale in transposition and tricuspid atresia; the differentiation of pulmonary atresia from critical pulmonary stenosis and the measurement of maximum velocity of tricuspid regurgitation.
Ideally all patients should undergo colour Doppler studies before cardiac surgery to ensure a more accurate diagnosis. However, since the additional information provided does not affect the management in most patients, machines without colour Doppler can provide a satisfactory service in paediatric cardiology centres in countries where resources are limited.
评估彩色多普勒在先天性心脏病超声评估中提供的额外信息。
对215例有先天性心脏病临床症状的儿童(年龄范围1天至16岁)进行前瞻性研究。
彩色多普勒对于诊断异常左冠状动脉至关重要,并改变了一名最初被诊断为心肌病患者的治疗方案。在以下情况中,彩色多普勒提供了额外信息,但对治疗方案没有重大影响:与其他缺陷相关的室间隔缺损、多发性室间隔缺损、肺静脉异常引流以及轻度二尖瓣反流的诊断;缩窄部位、狭窄或发育不全的肺动脉分支、通过右心房隔膜的无梗阻血流以及左心室至右心房反流的显示;在大动脉转位和三尖瓣闭锁中评估动脉导管宽度和通过卵圆孔未闭的血流;区分肺动脉闭锁与严重肺动脉狭窄以及测量三尖瓣反流的最大速度。
理想情况下,所有患者在心脏手术前都应接受彩色多普勒检查,以确保更准确的诊断。然而,由于所提供的额外信息在大多数患者中并不影响治疗方案,在资源有限的国家,没有彩色多普勒功能的仪器在儿科心脏病中心也能提供令人满意的服务。