Ultrasonic Diagnostic Value And Clinical Application Of The Conotruncal Defects Of Heart

BackgroundConotruncal defects(CTD) of heart was a kind of serious harm to human health of complicated cyanotic congenital heart disease, due to the existence of serious disorder of hemodynamics, the majority of patients not after treatment in the early death or by surgical treatment, but the effect was poor and the mortality was high. Ultrasound cardiogrm(UCG) examination was convenient, fast, cheap, simple, and could be operated by the bedside, the abnormal cardiac structure could be clearly displayed, and could evaluate the heart function and pulmonary artery pressure.ObjectiveUsing ultrasound cardiogrm(UCG) and its three-dimensional reconstruction, the characteristics of imaging diagnosis of conotruncal defects(CTD) were analyzed, the angle, distance and area of cone deflection were observed. The clinical application value of ultrasound cardiogrm(UCG) in diagnosis and differential diagnosis of conotruncal defects (CTD) was discussed.MethodsCollecting 295 patients with conotruncal defects(CTD) were treated with surgical treatment, and 16 cases with normal controls were selected from the Third Affiliated Hospital and the First Affiliated Hospital of Xinxiang Medical College, between June 2015 to January 2010. The clinical and imaging data of all patients were collected and "gold standard" after surgical diagnosis, to evaluate the sensitivity, specificity and accuracy of the ultrasound cardiogrm(UCG) and angiocardiography(ACG) in the diagnosis of conotruncal defectss(CTD), and the accuracy and validity of the ultrasound cardiogrm(UCG) and angiocardiography(ACG) were compared. In the three-dimensional ultrasound cardiogrm(UCG), the angle, distance and area of cone deflection of the conotruncal defects(CTD) and the normal control group were observed respectively, to compare the differences between the lesion group and the normal control group. The data were statistically analyzed by SPSS 13.0 software, and measurement data using mean± standard deviation(x±s).Results1. Ultrasound cardiogrm(UCG) could clearly show the lesion type and location of the conotruncal defects(CTD) of heart. In 295 cases of conotruncal defects(CTD) of heart patients, the proportion of the disease respectively, the tetralogy of Fallot(TOF) was 48.47%(143/295), transposition of the great arteries(TGA) was 18.65%(55/295), persistent truncus arteriosus(PTA) was 9.15%(27/295), double-outlet right ventricle(DORV) was 14.58%(43/295), pulmonary atresia with ventricular septal defect(PA/VSD) was 5.42% (16/295), aortopulmonary fistula(A-PW) was 3.73%(11/295).2. Ultrasound cardiogrm(UCG) and angiocardiography(ACG), surgical results were compared, ultrasound cardiogrm(UCG) in the diagnosis of conotruncal defectss(CTD) with a sensitivity was 92.14%, specificity was 98.03%,compliance rate was 97.85%,the sensitivity of the angiocardiography(ACG) was 97.62%, specificity was 99.18%, the coincidence rate was 99.07%. There was significant difference between the coincidence rate of pulmonary atresia with ventricular septal defect(PA/VSD) (P<0.05), and the sensitivity, specificity and coincidence rate of conotruncal defectss(CTD) in the ultrasound cardiogrm(UCG) and angiocardiography(ACG) was no significant difference(P>0.05).3. In three-dimensional ultrasound cardiogrm(UCG) of the anteroposterior, left-right section, the measurement of the cone deflection angle, maximum distance, area ware double-outlet right ventricle(DORV) group > persistent truncus arteriosus(PTA) and pulmonary atresia with ventricular septal defect(PA/VSD) group > tetralogy of Fallot(TOF) group > transposition of the great arteries(TGA) group > normal control group, except the transposition of the great arteries(TGA) group of three indicators, there were significant difference the other groups were between the normal control group(P<0.05). In the superioinferior section, the measurement of the cone deflection angle was the normal control group > transposition of the great arteries(TGA) group > tetralogy of Fallot(TOF) group > double-outlet right ventricle (DORV) group > persistent truncus arteriosus(PTA) and pulmonary atresia with ventricular septal defect(PA/VSD) group, there were significant differences between the lesion groups and normal control group(P<0.05), but there were no significant differences between the lesion groups (P>0.05). Measurement of the cone deflection maximum distance and area were persistent truncus arteriosus(PTA) and pulmonary atresia with ventricular septal defect(PA/VSD) group > double-outlet right ventricle(DORV) group > tetralogy of Fallot(TOF) group > transposition of the great arteries(TGA) group > normal control group, except the persistent truncus arteriosus(PTA) and pulmonary atresia with ventricular septal defect(PA/VSD) group, the other three groups and the normal control group were no significant difference(P>0.05).Conclusions1. Ultrasound cardiogrm(UCG) was a high diagnostic rate for the diagnosis of conotruncal defectss(CTD), and could be used as the first choice for the diagnosis of conotruncal defectss(CTD).2. Three dimensional ultrasound cardiogrm(UCG) provided a quantitative basis for the diagnosis of conotruncal defectss(CTD), which could further improve the diagnostic accuracy of the conotruncal defects(CTD).