Robinson P J, Sullivan I D, Kumpeng V, Anderson R H, Macartney F J
Br Heart J. 1984 Sep;52(3):272-7. doi: 10.1136/hrt.52.3.272.
Cross sectional echocardiography can identify anomalous origin of the left coronary artery from the pulmonary trunk. It has been suggested that identification of the left coronary artery arising from the aorta using this technique excludes the diagnosis. In three such infants the anomalous origin of the left coronary artery was identified in each by cross sectional echocardiography. In all three cases, however, an echo free linear structure apparently arising from the aorta, resembling a normal left coronary artery, was imaged. Anatomical sections in one patient, simulating cross sectional echocardiographic cuts, showed that this structure was almost certainly the transverse sinus of the pericardium. False positive cross sectional echocardiographic diagnosis of this condition is also possible because of the failure to image a normally arising left coronary artery. Thus identification of the anomalous origin of the left coronary artery from the pulmonary trunk appears to be the only reliable echocardiographic finding in this condition, and contrast cineaortography remains necessary in patients in whom the diagnosis is suspected clinically or electrocardiographically.
横断面超声心动图可识别左冠状动脉起源于肺动脉干的异常情况。有人提出，使用该技术识别出左冠状动脉起源于主动脉可排除该诊断。在三名此类婴儿中，通过横断面超声心动图均识别出了左冠状动脉起源异常。然而，在所有三例中，均成像出一个明显起源于主动脉、类似正常左冠状动脉的无回声线性结构。一名患者的解剖切片模拟横断面超声心动图切面显示，该结构几乎肯定是心包横窦。由于未能成像出正常起源的左冠状动脉，这种情况的横断面超声心动图假阳性诊断也是可能的。因此，识别左冠状动脉起源于肺动脉干的异常情况似乎是这种情况下唯一可靠的超声心动图表现，对于临床或心电图怀疑有该诊断的患者，对比主动脉造影仍有必要。
