【摘要】 目的对比分析心脏超声高频探头及低频探头在儿童冠状动脉检查中的应用,包括图像质量、冠状动脉内径测量的精确度以及冠状动脉扩张及冠状动脉瘤的诊断等,以期为临床提供更为准确的辅助诊断方法。方法选取2014年11月至2015年11月在首都儿科研究所附属儿童医院诊断为川崎病的215例患儿行心脏超声检查,每例均对左、右冠状动脉进行测量,包括左冠状动脉主干(LM)、前降支(LAD)、回旋支(LCX)及右冠状动脉(RCA),其中12例行冠状动脉CT血管成像(CTA)检查,并对比分析高频探头(S12-3)、低频探头(S5-1)及CTA所获得冠状动脉图像的清晰度,冠状动脉内径及冠状动脉扩张、冠状动脉瘤的数量。结果采用心脏超声高频探头较低频探头所获得的图像对比度强、分辨率高,左、右冠状动脉开口及近端走形显示清晰,内膜图像均匀无颗粒感,而低频探头对低龄儿尤其婴儿图像显示欠佳,内膜模糊,边界不清;运用高频探头测得的冠状动脉内径值与CTA测值比较,差异无统计学意义(P>0.05),但低频探头测得冠状动脉内径值(LM、LAD、LCX、RCA)分别为(2.95±1.36)mm、(2.24±1.27)mm、(1.89±2.63)mm、(2.35±2.89)mm,与CTA测值[(2.67±0.42)mm、(2.03±0.64)mm、(1.56±0.48)mm、(2.07±0.47)mm]比较,差异有统计学意义(P值均<0.05);CTA检查发现冠状动脉瘤个数最多,低频探头次之,高频探头最少。结论高频探头更适合婴幼儿川崎病冠状动脉的检查,超声图像更为清晰,所获得的数据更为可靠及准确,且无创,方便,更适合川崎病急性期诊断及门诊随访时使用。更多还原

【Abstract】 Objective To analysis the difference between the application of high-frequency probe and the use of low-frequency probe in detecting the coronary arteries in children by using echocardiography, including the imaging quality, inner diameter of the coronary artery, and coronary artery dilation to facilitate clinical diagnosis. Methods From November 2014 to November 2015, 215 children who were diagnosed as Kawasaki disease, underwent echocardiography examination in Capital Institute of Pediatrics. Twelve cases did the examination of the computed tomography angiography and echocardiography using high-frequency probe(S12-3) and the low-frequency probe(S5-1). The imaging quality, coronary artery size and the number of coronary artery dilation were compared after the examination. Results The imaging obtained by the use of high-frequency probe showed stronger contrast, higher resolution than using the lower-frequency probe. The opening of left and right coronary artery and the proximal part were showed extremely clear and the imaging of intima was echo-homogeneous. While the imaging of the low-frequency probe for young children, especially for babies was discovered poorly, with blurred intima and ill-defined margin. The diameter of coronary artery in high-frequency probe imaging was not significant different with CT images(P > 0.05), but the data obtained from the low-frequency probe [(2.95±1.36) mm,(2.24±1.27) mm,(1.89±2.63) mm,(2.35±2.89) mm] was different with CT [(2.67±0.42) mm,(2.03±0.64) mm,(1.56±0.48) mm,(2.07±0.47) mm](P < 0.05). The maximum number of coronary artery dilation got from CT, second was that from the use of low-frequency probe, and followed by the use of high-frequency probe. Conclusions The high-frequency probe was more suitable for detecting coronary artery disease in KD infants. The images were more distinctewith more reliable data, and the examination was non-invasive, safe, and convenient.It was more appropriate for the diagnosis ofacute phase Kawasaki disease and patient follow-up in clinic.更多还原