Department of Echocardiography, Fuwai Hospital, National Center for Cardiovascular Diseases, China.
Department of Function, The Second Central Hospital of Baoding City, Zhuozhou 72750, China.
Biomed Res Int. 2019 Jun 19;2019:4919416. doi: 10.1155/2019/4919416. eCollection 2019.
Imaging artifacts are frequently encountered when performing clinical echocardiography. Based on our review of the literature, two-dimensional linear artifacts are mainly reported in the ascending aorta in patients with suspected aortic dissections. However, pulmonary artery artifacts that mimic pulmonary artery dissection have not been discussed. We herein report our experience with children and adults with preexisting heart conditions and pulmonary artery imaging artifacts.
The study population comprised 10 patients with heart disease who were treated at our hospital from March 2015 to September 2017. Nine patients were children with congenital heart disease, mainly patent ductus arteriosus (n = 8), and one patient was an adult with pulmonary artery hypertension. Transthoracic echocardiography was performed in all patients.
We confirmed the diagnosis in six patients during a surgical operation for other indications and in four patients by computed tomographic pulmonary angiography. The most common pulmonary imaging artifact was observed from the left high parasternal view (9/10, 90%). Most of the artifacts were diagonally oriented (8/10, 80%), and a few were horizontally oriented. Half of the artifacts were located in the main pulmonary arteries with mild pulmonary artery dilatation. Pulmonary hypertension was seen only in the adult patient. The thymus gland was clearly seen in young patients.
Pulmonary artery imaging artifacts in patients with preexisting heart disease during echocardiographic examination can mimic pulmonary artery dissection. Understanding the types and origins of these ultrasound artifacts is important to avoid a false-positive diagnosis.
在进行临床超声心动图检查时，经常会遇到成像伪影。根据我们对文献的回顾，二维线性伪影主要在疑似主动脉夹层的患者升主动脉中报告。然而，尚未讨论模拟肺动脉夹层的肺动脉伪影。本文报告了我们在患有先心病和肺动脉成像伪影的儿童和成人患者中的经验。
研究人群包括 2015 年 3 月至 2017 年 9 月在我院治疗的 10 例心脏病患者。9 例为先天性心脏病患儿，主要为动脉导管未闭（n = 8），1 例为肺动脉高压成人。所有患者均进行经胸超声心动图检查。
我们在 6 例因其他指征进行手术的患者中以及在 4 例通过计算机断层肺动脉造影检查中确认了诊断。最常见的肺部成像伪影是从左侧胸骨旁高位观察到的（9/10，90%）。大多数伪影呈对角线方向（8/10，80%），少数呈水平方向。一半的伪影位于主肺动脉内，伴有轻度肺动脉扩张。仅在成年患者中发现肺动脉高压。年轻患者的胸腺清晰可见。
在超声心动图检查中，患有先心病的患者的肺动脉成像伪影可以模拟肺动脉夹层。了解这些超声伪影的类型和来源对于避免假阳性诊断很重要。
