Liu Jinqiao,Chen Wenjuan,Hu Yuan,et al.Diagnostic value of Berry syndrome by color Doppler echocardiography[J].Journal of Clinical Pediatric Surgery,2020,19(04):353-357.[doi:10.3969/j.issn.1671-6353.2020.04.014]
彩色多普勒超声心动图对Berry综合征的诊断价值研究
- Title:
- Diagnostic value of Berry syndrome by color Doppler echocardiography
- Keywords:
- Ultrasongraphy; Doppler; Color; Echocardiography; Berry syndrome; CT Vascular Reconstruction
- 分类号:
- R54;R540.4+5
- 摘要:
- 目的 分析归纳Berry综合征的超声声像图特点，探讨彩色多普勒超声心动图对Berry综合征的诊断价值。方法 以2010年4月至2019年11月在湖南省儿童医院经超声心动图诊断为Berry综合征的8例患儿为研究对象，采用PHILIPS IE33型及PHILIPS EPIQ 7C型彩色多普勒超声心动图诊断仪，配S5-1、S8-3、X7-2探头，频率2.5~7.5MHz。除常规扫查切面外，重点扫查大动脉短轴切面、右室流出道肺动脉长轴切面、胸骨上窝主动脉弓长轴切面、剑突下切面等，仔细观察主动脉与肺动脉的间隔连续情况，肺动脉主干走形及左、右肺动脉分支起源，主动脉弓顶端分支结构及远端与降主动脉延续情况等。结果 8例Berry综合征患儿均进行彩色多普勒超声心动图检查，其中7例诊断为Berry综合征，1例术前超声心动图仅仅诊断为动脉导管未闭、主动脉弓缩窄，后经CT血管重建证实Berry综合征并接受手术治疗。患儿心脏畸形包括：Ⅱ型主-肺动脉间隔缺损（8例）、右肺动脉异常起源主动脉（8例）、主动脉弓离断（7例）、主动脉弓狭窄（1例）、动脉导管未闭（8例），8例室间隔连续且完整，均合并肺动脉高压、三尖瓣轻至中度反流；7例合并卵圆孔未闭。7例经手术治疗痊愈，1例合并重度肺动脉高压、重症肺炎于术前死亡。结论 彩色多普勒超声心动图作为一种无创检查方法，能较直观地显示Berry综合征的各种畸形，对于临床疑诊病例，需联合CT血管重建，做出准确判断。
- Abstract:
- Objective To explore the value of color echocardiography in the diagnosis of Berry syndrome.Methods Eight children with Berry syndrome were diagnosed by color Doppler echocardiography from April 2010 to November 2019.PHILIPS IE33 and PHILIPS EPIQ 7C color Doppler echocardiography diagnostic instruments with S5-1,S8-3,X7-2 probes at a frequency of 2.5-7.5MHz were operated for conventional scans and short-axis view of aorta,long-axis view of pulmonary artery in right ventricular outflow tract,long-axis view of aortic arch of sternum and lower section of xiphoid.Main trunk shape and origin of left and right pulmonary artery branches,top branch structure of aortic arch and continuity of distal and descending aorta were observed.Results Eight patients with confirmed Berry syndrome underwent color Doppler echocardiography.Seven of them were diagnosed as Berry syndrome.One patient with preoperative echocardiography was diagnosed only with open ductus and narrowed aortic arch.After Berry syndrome was confirmed by CT vascular reconstruction,surgery was performed.Cardiac malformations included type Ⅱ aorta-pulmonary septal defect (n=8),right aortic abnormal origin aorta (n=8),aortic arch rupture (n=7),aortic arch stenosis (n=1) and open artery duct (n=8).Ventricular septum was continuous and intact and there were pulmonary hypertension and mild-to-moderate regurgitation of tricuspid valve; 7 cases with oval foramen were not closed.Seven children were cured by surgery.One child with severe pulmonary hypertension and severe pneumonia died preoperatively. Conclusion As a non-invasive examination modality,color echocardiography can more intuitively depict various malformations of Berry syndrome.A definite clinical diagnosis should be made in conjunctions with the findings of CT vascular reconstruction.
参考文献/References:
1 Li W,Bin G,Jiang W,et al.Prenatal diagnosis of aortopulmonary window by 2-dimensional echocardiography:summary of 8 cases[J].J Ultrasound Med,2019,38(3):795-803.DOI:10.1002/jum.14756.
2 Bu H,Zhao T.Berry syndrome diagnosed by three-dimensional computed tomographic angiography[J].Acta Cardiol,2020,75(2):160-161.DOI:10.1080/00015385.2018.1557408.
3 Zhang X,Liu XW,Gu XY,et al.Prenatal diagnosis of Berry syndrome by fetal echocardiography:A report of four cases[J].Echocardiography,2018,35(4):563-565.DOI:10.1111/echo.13832.
4 Kumar SR.A potential window into surgical outcomes for Berry syndrome[J].J Thorac Cardiovasc Surg,2017,153(5):1148-l149.DOI10.1016/j.jtcvs.2017.01.041.
5 Remon JI,Briston DA,Stern KW.Berry syndrome:the importance of genetic evaluation before surgical intervention[J].Cardiol Young,2016,26(1):188-190.DOI:10.1017/S1047951115000256.
6 徐彦成,刘祎秀,杨静.6例主肺动脉窗合并主动脉弓离断的超声心动图及心脏造影诊断价值[J].中国心血管病研究,2018,16(9):816-819.DOI:10.3969/j.issn.1672-5301.2018.09.010. Xu YC,Liu YX,Yang J.Diagnostic value of ultrasound and cardiac angiography in 6 cases of aorto-pulmonary window combined with interrupted aortic arch[J].Chinese Journal of Cardiovascular Research,2018,16(9):816-819.DOI:10.3969/j.issn.1672-5301.2018.09.010.
7 赵梦峤,任卫东,胡金玲.7例主肺间隔缺损患者超声特征分析[J].中国医科大学学报,2018,47(2):171-174.DOI:10.12007/j.issn.02584646.2018.02.017. Zhao MJ,Ren WD,Hu JL.Characterization of ultrasonic echocardiography in seven patients with aortopulmonary septal defect[J].Journal of China Medical University,2018,47(2):171-174.DOI:10.12007/j.issn.02584646.2018.02.017.
8 缪伟,姜伊娜,王翠翠.Berry综合征产前超声心动图表现1例[J].中国临床医学影像杂志,2017,28(1):48.DOI:10.3969/j.issn.1008-1062.2017.01.013. Liao W,Jiang YN,Wang CC.Prenatal echocardiographic findings of Berry syndrome:report of one case[J].Journal of China Clinic Medical Imaging,2017,28(1):48.DOI:10.3969/j.issn.1008-1062.2017.01.013.
9 王佳莉,任卫东,胡金玲.超声心动图诊断罕见Berry综合征二例[J].中华医学超声杂志(电子版),2017,14(3):239-240.DOI:10.3877/cma.j.issn.1672-6448.2017.03.015. Wang JL,Ren WD,Hu JL.Echocardiographic diagnosis of rare Berry syndrome:a report of two cases[J].Chinese Journal of Medical Ultrasound (Electronic Edition),2017,14(3):239-240.DOI:10.3877/cma.j.issn.1672-6448.2017.03.015.
10 Berry TE,Bharati S,Muster AJ,et al.Distal aortopulmonary septal defect,aortic origin of the right pulmonary artery,intact ventricular septum,patent ductus arteriosus and hypoplasia of the aortic isthmus:a newly recognized syndrome[J].Am J Cardiol,1982,49(1):108-116.DOI:10.1016/0002-9149(82)90284-3.
11 Soquet J,Barron DJ,d’Udekem Y.A review of the management of pulmonary atresia,ventricular septal defect and major aortopulmonary collateral arteries[J].Ann Thorac Surg,2019,108(2):601-612.DOI:10.1016/j.athoracsur.2019.01.046.
12 Talwar S,Agarwal P,Choudhary SK,et al.Aortopulmonary window:morphology,diagnosis,and long-term results[J].Journal of Cardiac Surgery,2017,32(2):138-144.DOI:10.1111/jocs.12936.
13 Friedman,Kevin.Preoperative physiology,imaging,and management of interrupted aortic arch[J].Seminars in Cardiothoracic & Vascular Anesthesia,2017,22(3),265-269.DOI:10.1177/1089253218770198.
14 Houssa MA,Atmani N,Bamous M,et al.Persistence of the 5th Aortic Arch Associated With Interruption of the Aortic Arch[J].Pan Afr Med J,2017,27:265.DOI:10.11604/pamj.2017.27.265.4249.
15 Ghelani SJ,Quinonez LG,Rathod RH.Prenatal diagnosis and management of Berry syndrome,a rare conotruncal anatomy[J].Circulation,2015,132(16):1593-1594.DOI:10.1161/CIRCULATIONAHA.115.017366.
16 Jayaram N,Knowlton J,Shah S,et al.Berry syndrome:a possible genetic link[J].Pediatr Cardiol,2013,34(6):1511-1513.DOI:10.1007/s00246-012-0412-7.
17 Presnell LB,Blankenship A,Cheatham SL,et al.An overview of pulmonary atresia and major aortopulmonary collateral arteries[J].World J Pediatr Congenit Heart Surg,2015,6(4):630-639.DOI:10.1177/2150135115598559.
18 Morito H,Masuzawa A,Kobayashi J,et al.One-stage surgical repair for Berry syndrome with preoperative diagnosis by 3-dimensional CT[J].World J Pediatr Congenit Heart Surg,2011,2(3):491-494.DOI:10.1177/2150135111405347.
19 Senzaki H,Asano H,Masutani S,et al.Anomalous origin of the Left coronary artery from the main pulmonary artery associated with Berry syndrome[J].J Thorac Cardiovasc Surg,2003,126(5):1645-1647.DOI:10.1016/s0022-5223(03)00957-7.
20 胡仁杰,张文,刘鑫荣,等.19例Berry综合征的外科治疗[J].中华胸心血管外科杂志,2018,34(12):713-716.DOI:10.3760/cma.j.issn.1001-4497.2018.12.002. Hu RJ,Zhang W,Liu XR,et al.Surgery treatment of Berry syndrome:a report of 19 cases[J].Chinese Journal of Thoracic and Cardiovascular Surgery,2018,34(12):713-716.DOI:10.3760/cma.j.issn.1001-4497.2018.12.002.
相似文献/References:
[1]俞钢 朱小春 葛午平 林炎坤 金龙 劳伟华 史浩 肖尚杰 洪淳 周佳亮 傅晓静. 胎儿外科相关疾病的产前诊断及干预[J].临床小儿外科杂志,2011,10(02):111.
The antenatal diagnosis, tassessment, and therapy of fetal surgical anomalies[J].Journal of Clinical Pediatric Surgery,2011,10(04):111.
[2]解承兰,张兰,傅廷亮,等.胎儿腹部病变的产前诊断及围产期处理[J].临床小儿外科杂志,2007,6(02):5.
[3]刘辉,林琼,傅忠,等.超声诊断先天性肥厚性幽门狭窄20例[J].临床小儿外科杂志,2007,6(02):20.
[4]罗远建,金科,甘青,等.儿童神经母细胞瘤的影像学表现[J].临床小儿外科杂志,2007,6(02):22.
[5]李长春 王珊 章均 欧阳军 孔祥如 杨超 赵珍珍 吕麟亚. B超引导下芯针穿刺活检术诊断儿童实体肿瘤的临床分析[J].临床小儿外科杂志,2011,10(04):247.
[J].Journal of Clinical Pediatric Surgery,2011,10(04):247.
[6]周路遥 何秋明 朱莉玲 张遇乐 贺雪华 符柳江 夏慧敏. 术前超声评估可疑阑尾炎123例分析[J].临床小儿外科杂志,2011,10(04):270.
[J].Journal of Clinical Pediatric Surgery,2011,10(04):270.
[7]陈文娟 段星星 李皓 张雪华 胡原 张号绒. 高频超声对疑似发育性髋关节异常患儿髋关节发育的评估价值[J].临床小儿外科杂志,2011,10(05):345.
[J].Journal of Clinical Pediatric Surgery,2011,10(04):345.
[8]张豪 钱蔷英 阮双岁. 424例儿童阴囊内疾病的超声诊断分析[J].临床小儿外科杂志,2011,10(05):357.
[J].Journal of Clinical Pediatric Surgery,2011,10(04):357.
[9]张丽意 蒋国平 叶菁菁 江晶晶. 单侧隐睾症患者睾丸大小及位置的术前超声评估[J].临床小儿外科杂志,2012,11(04):254.
[J].Journal of Clinical Pediatric Surgery,2012,11(04):254.
[10]林启发 朱小瑜 叶素芬. 高频超声在新生儿锁骨骨折中的诊断价值探讨[J].临床小儿外科杂志,2012,11(06):412.
[J].Journal of Clinical Pediatric Surgery,2012,11(04):412.
[11]刘金桥 何静波 陈文娟 陈叶 杨芳 尹海燕.高频超声及彩色多普勒对小儿睾丸肿瘤的诊断价值[J].临床小儿外科杂志,2011,10(02):130.
[J].Journal of Clinical Pediatric Surgery,2011,10(04):130.
[12]李萌,于增文,李索林,等.超声多普勒血管显像在内结扎法腹腔镜脾切除术中的应用[J].临床小儿外科杂志,2008,7(03):4.
[13]张号绒 何静波 周崇高. 彩色多普勒超声对儿童肠扭转的诊断价值[J].临床小儿外科杂志,2012,11(01):34.
[14]林海 覃伶伶 林国雄 李权. 新生儿肠旋转不良并急性中肠扭转的诊治探讨[J].临床小儿外科杂志,2012,11(01):39.
[J].Journal of Clinical Pediatric Surgery,2012,11(04):39.
[15]倪洁 孙颖华 钱蔷英. 彩色多普勒超声对于儿童先天性巨输尿管症的诊断价值[J].临床小儿外科杂志,2013,12(06):445.
[16]张号绒,侯艳青,许云峰,等.彩色多普勒超声对儿童鳃裂畸形的诊断价值[J].临床小儿外科杂志,2021,20(05):464.[doi:10.12260/lcxewkzz.2021.05.013]
Zhang Haorong,Hou Yanqing,Xu Yunfeng,et al.Diagnostic value of color Doppler ultrasonography in children with branchial cleft deformity[J].Journal of Clinical Pediatric Surgery,2021,20(04):464.[doi:10.12260/lcxewkzz.2021.05.013]
备注/Memo
收稿日期:2019-07-30。
基金项目:湖南省发改委基金（编号：湘发改投资[2014]658号）
通讯作者:周启昌,Email:hnzqc2013@163.com