Liu Qianjun, Hu Yuan, Peng Yinghui, Li Wenfeng, Chen Wenjuan, Luo Jinwen, Liu Jinqiao, Deng Xicheng
Department of Ultrasound, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China.
Department of Cardiothoracic Surgery, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China.
Front Pediatr. 2025 Jul 15;13:1541643. doi: 10.3389/fped.2025.1541643. eCollection 2025.
This study aimed to investigate the clinical value of abdominal aortic spectral Doppler combined with echocardiography in the diagnosis of aortic coarctation in pediatric patients.
Pediatric patients with aortic coarctation, diagnosed by computed tomography angiography (CTA) and surgically confirmed, were retrospectively enrolled. These patients were divided into two groups based on the availability of abdominal aortic spectral Doppler. Additionally, both abdominal aortic spectral Doppler and echocardiographic data were collected for the normal group. All data were compared and analyzed to determine the reasons for discrepancies in diagnostic results.
No significant differences were observed in baseline characteristics among the three groups ( > 0.05). There were statistically significant differences in aortic isthmus velocity and aortic isthmus -scores between the normal group and the two patient groups ( < 0.05), but there were no significant differences in aortic isthmus velocity or aortic isthmus -scores between the two patient groups ( > 0.05). The abdominal aortic spectral Doppler group demonstrated significantly decreased peak systolic velocity (PSV), prolonged acceleration time (AT), and reduced pulsatility index (PI) and resistance index (RI) compared with controls ( < 0.05). Echocardiographic detection rates differed between groups: non-abdominal aortic spectral Doppler group, 59 true-positive coarctation cases (sensitivity 85.5%, false-negative rate 14.5%); abdominal aortic spectral Doppler group, 75 true-positive cases (sensitivity 96.2%, false-negative rate 3.8%). The combined diagnostic model incorporating abdominal aortic PSV, AT, and aortic isthmus -score achieved superior performance (AUC = 0.98), significantly outperforming individual parameters.
Abdominal aortic spectral Doppler combined with echocardiography can improve the diagnostic sensitivity of aortic coarctation in pediatric patients and can be used as an important indirect imaging approach in clinical practice to reduce missed diagnoses of aortic coarctation.
本研究旨在探讨腹主动脉频谱多普勒联合超声心动图在小儿主动脉缩窄诊断中的临床价值。
回顾性纳入经计算机断层血管造影（CTA）诊断并经手术证实的小儿主动脉缩窄患者。根据是否有腹主动脉频谱多普勒，将这些患者分为两组。此外，收集正常组的腹主动脉频谱多普勒和超声心动图数据。对所有数据进行比较和分析，以确定诊断结果差异的原因。
三组间基线特征无显著差异（>0.05）。正常组与两组患者组之间在主动脉峡部速度和主动脉峡部评分上存在统计学显著差异（<0.05），但两组患者组之间在主动脉峡部速度或主动脉峡部评分上无显著差异（>0.05）。与对照组相比，腹主动脉频谱多普勒组的收缩期峰值速度（PSV）显著降低、加速时间（AT）延长、搏动指数（PI）和阻力指数（RI）降低（<0.05）。超声心动图检测率在各组间有所不同：非腹主动脉频谱多普勒组，59例缩窄真阳性病例（敏感性85.5%，假阴性率14.5%）；腹主动脉频谱多普勒组，75例真阳性病例（敏感性96.2%，假阴性率3.8%）。结合腹主动脉PSV、AT和主动脉峡部评分的联合诊断模型表现更优（AUC = 0.98），显著优于单个参数。
腹主动脉频谱多普勒联合超声心动图可提高小儿主动脉缩窄的诊断敏感性，可作为临床实践中的一种重要间接成像方法，以减少主动脉缩窄的漏诊。
