Xie Manying, Yin Jiabao, Lv Qing, Wang Jing
Department of Ultrasound Imaging, Xiangyang Hospital Affiliated to Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China.
Department of Ultrasound Imaging, Xiehe Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China.
Exp Ther Med. 2016 Nov;12(5):3315-3319. doi: 10.3892/etm.2016.3747. Epub 2016 Sep 23.
In order to assess the clinical value of echocardiography in the diagnosis of aortico-left ventricular tunnel (ALVT) the echocardiographic data and clinical manifestations of six patients with ALVT were analyzed in the present study. Based on the results, a comprehensive study was conducted regarding 147 cases from related documents. Six patients were confirmed with ALVT by surgery. The echocardiographic images of the patients revealed an abnormal communication beginning in the ascending aorta above the coronary arteries, bypassing the aortic valve, and ending in the left ventricle. The color Doppler flow imaging showed a high-speed to- and -fro flow with or without the involvement of the aortic valve. According to Hovaguimian type casting, there were two cases of type I, two cases of type III, one case of type IV, and one case of type II (postoperative recanalization). Of the 153 cases reported, the accuracy rate of the ultrasound diagnosis was 79.6%, the misdiagnosis rate was 17.1%, and the missed diagnostic rate was 3.3%. In conclusion, echocardiography is the preferred method for non-invasive preoperative diagnosis of the ALVT and can accurately describe the type and involvement of the cardiac structure.
为评估超声心动图在主动脉-左心室隧道（ALVT）诊断中的临床价值，本研究分析了6例ALVT患者的超声心动图数据及临床表现。基于这些结果，对相关文献中的147例病例进行了综合研究。6例患者经手术确诊为ALVT。患者的超声心动图图像显示，异常通道始于冠状动脉上方的升主动脉，绕过主动脉瓣，止于左心室。彩色多普勒血流成像显示有高速往返血流，主动脉瓣可受累或不受累。根据Hovaguimian分型，Ⅰ型2例，Ⅲ型2例，Ⅳ型1例，Ⅱ型（术后再通）1例。在报道的153例病例中，超声诊断准确率为79.6%，误诊率为17.1%，漏诊率为3.3%。总之，超声心动图是ALVT无创术前诊断的首选方法，可准确描述心脏结构的类型及受累情况。
