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经超声心动图诊断右冠状动脉起源于肺动脉异常。

Diagnosis of anomalous origin of the right coronary artery from the pulmonary artery by echocardiography.

作者信息

Wu Lan-Ping, Zhang Yu-Qi, Chen Li-Jun, Liu Yi-Qing

机构信息

Department of Pediatric Cardiology, Shanghai Children'S Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, People's Republic of China.

出版信息

J Med Ultrason (2001). 2019 Jul;46(3):335-341. doi: 10.1007/s10396-019-00933-7. Epub 2019 Feb 21.

DOI:10.1007/s10396-019-00933-7
PMID:30790093
Abstract

PURPOSE

To review the imaging characteristics and evaluate the diagnostic value of echocardiography for diagnosing anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA).

METHODS

We retrospectively reviewed the echocardiographic records and compared these images with operative findings in six children with ARCAPA.

RESULTS

ARCAPA was characterized by dilation of the left coronary artery, inappropriate origin of the right coronary artery from the pulmonary artery, and collaterals within the interventricular septum. The associated malformations included atrial septal defect in four cases. Four of six cases were diagnosed correctly, while the remaining two cases were misdiagnosed: one of fistula between the pulmonary artery and the left coronary artery and another of ARCAPA diagnosed intraoperatively in one case of atrial septal defect.

CONCLUSION

ARCAPA can be diagnosed by echocardiography but is prone to misdiagnosis. This malformation should be distinguished from coronary artery fistula.

摘要

目的

回顾超声心动图对诊断右冠状动脉起源于肺动脉(ARCAPA)的成像特征并评估其诊断价值。

方法

我们回顾性分析了6例ARCAPA患儿的超声心动图记录,并将这些图像与手术结果进行比较。

结果

ARCAPA的特征为左冠状动脉扩张、右冠状动脉起源于肺动脉异常以及室间隔内存在侧支循环。相关畸形包括4例房间隔缺损。6例中有4例诊断正确,其余2例误诊:1例误诊为肺动脉与左冠状动脉瘘,另1例在1例房间隔缺损手术中术中诊断为ARCAPA。

结论

ARCAPA可通过超声心动图诊断,但容易误诊。这种畸形应与冠状动脉瘘相鉴别。

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本文引用的文献

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An incidentally detected anomalous origin of the right coronary artery from the pulmonary artery in an infant.一名婴儿偶然发现右冠状动脉起源于肺动脉异常。
Arch Argent Pediatr. 2018 Feb 1;116(1):e102-e105. doi: 10.5546/aap.2018.eng.e102.
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Anomalous Origin of Right Coronary Artery Originating from the Pulmonary Trunk (ARCAPA): an Incidental Finding in a Patient Presenting with Chest Pain.起源于肺动脉干的右冠状动脉异常起源(ARCAPA):一名胸痛患者的偶然发现。
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肺动脉闭锁、室间隔缺损及主要主肺动脉侧支动脉中的先天性矫正型大动脉转位
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