目的：通过腹腔剑下切面观察下腔静脉（IVC），腹主动脉（AO）和奇静脉的位置关系，探讨剑下切面腹腔大血管解剖关系异常与小儿内脏异位综合征及先天性心血管畸形（CCVD）的关系。方法：对超声诊断腹腔大血管异常的91例小儿进行分型，分为3型，Ⅰ型：下腔静脉消失、奇静脉扩张；Ⅱ型：腹主动脉和下腔静脉位于脊柱同侧；Ⅲ型：AO和IVC反位，均经多层螺旋CT（MSCT）或手术或尸解证实，就不同类型腹腔剑下切面大血管关系和内脏异位综合征及CCVD的相关性进行分析。结果：在腹腔剑下切面大血管解剖关系异常91例中，Ⅰ型8例，包括多脾并左侧异构的CCVD 7例，脾脏和心脏正常1例；Ⅱ型29例中，无脾27例，右侧异构的CCVD 29例；Ⅲ型54例中，内脏镜面反位53例，包括CCVD 27例，其中1例无脾，左侧异构。结论：腹腔大血管解剖关系异常，常提示小儿存在内脏异位综合征、内脏反位合并有CCVD，应作为小儿CCVD的常规检查切面。
Abstract
Objective: To study the relationship of abdominal great vessels abnormalities, pediatric heterotaxy and congenital cardiovascular diseases(CCVD) by observing the positional relationship of inferior vena cava(IVC), abdominal aorta(AO) and vena azygos from subxiphoid view． Methods: Ninety-one cases of pediatric abdominal great vessels abnormalities diagnosed by ultrasonic examination and confirmed by MSCT, operation or autopsy were analyzed． These cases were divided into the following three categories. Type Ⅰ: absence of IVC and dilatation of azygos vein. Type Ⅱ: AO and IVC are on the same side of spine. Type Ⅲ: situs inversus of AO and IVC． The relationship of great vessels, heterotaxy and CCVD from different subxiphoid views were analyzed． Results: In the 91 cases of pediatric abdominal great vessels abnormalities observed from subxiphoid view, there were 8 cases of type Ⅰ， including 7 cases of CCVD with polysplenia and left isomerism, 1 case of normal spleen and heart; 29 cases of type Ⅱ, including 27 cases of asplenia syndrome, 29 cases of CCVD with right isomerism． Fifty-four cases of type Ⅲ, including 53 cases of situs inversus viscerum, 27 cases of CCVD with 1 case of asplenia syndrome and left isomerism. Conclusions: Abnormalities of abdominal great vessels often imply heterotaxy or situs inversus with different types of CCVD． It should be a routine inspection section for pediatric CCVD．
关键词
内脏；心血管畸形；儿童；超声检查 /
多普勒 /
彩色
Key words
Viscera /
Cardiovascular abnormalities /
Child /
Ultrasonography, Doppler, color
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