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本文报道6例三尖瓣下移畸形,X线平片表现心脏均为高度增大,呈球形(主要为右心房扩张所致),右心室漏斗部膨隆,肺动脉段凹陷,肺血管纹减少以及大血管影小。透视及记波片,除在心缘上部搏动较强外,其余心缘搏动均减弱。造影所见与以往文献报告一致。 文中强调了本症平片与法鲁氏四联症、三联症的鉴别诊断。四联症心影一般不大或轻度增大,右心室肥厚,主动脉增宽,心影呈靴状,故不难区别。下列各点有助于三联症的鉴别:(1)右房高/心高比值,本症比三联症更大。(2)三联症多有肺动脉段凸出,而本症则常见右心室漏斗部膨隆。(3)左肺动脉/右下肺动脉比值,三联症比本症增大显著(P<0.05)。 当本症平片诊断困难或因外科手术需要显示其病变解剖与血液动力学改变时,则必行右心导管及选择性右房造影检查。
This paper reports 6 cases of tricuspid valve deformity, X-ray showed a high degree of heart were enlarged, spherical (mainly due to the expansion of the right atrium), the right ventricular bulging funnel, pulmonary artery depression, reduced pulmonary vascular pattern and Small blood vessels shadow. Fluoroscopy and wave recording, in addition to the upper heart beat strong, the rest of the heart beats are weakened. Contrast with previous reports of the literature. The article emphasizes the differential diagnosis of the disease plain film and Farh’s tetralogy of Fallot, triple disease. Si Lianxiong generally no significant or mild increase in heart shadow, right ventricular hypertrophy, aortic widening, heart shadow was boot-shaped, it is not difficult to distinguish. The following points contribute to the identification of triad: (1) right atrial height / heart rate ratio, the disease more than triad. (2) triad disease more prominent pulmonary artery segment, while the disease is common to the right ventricular bulbar infundibulum. (3) The left pulmonary artery / right lower pulmonary artery ratio, triad disease than the disease increased significantly (P <0.05). When the diagnosis of plain film difficult or due to surgical need to show the anatomy of the lesion and hemodynamic changes, it will be right-heart catheterization and selective right atrial imaging.