【摘要】 目的 通过对18例心内膜垫缺损造影诊断与手术病理对比，分析其影像病理基础和漏、误诊原因，以期客观评价左室造影对心内膜垫缺损的诊断意义和局限性。 材料与方法 18例均行左室正位造影，其中6例并行侧位造影。18例均以心内直视手术修复。将造影诊断与手术结果进行对比。 结果 造影诊断部分型心内膜垫缺损12例，完全型心内膜垫缺损2例，左室右房通道2例，法鲁四联征1例，三尖瓣下移畸形1例。手术证实18例均为心内膜垫缺损，其中部分型11例(1例并法鲁四联征)，完全型2例，单心房腔型5例。造影诊断与手术结果完全相符8例(44%)，造影诊断分型错误6例，漏诊1例，误诊3例。 结论 左室造影是心内膜垫缺损术前重要的检查手段，具有特征性的诊断价值，但对非典型的造影表现尤其并存心脏及大血管其他畸形的造影表现，确诊较为困难，宜结合其他影像诊断手段。

ZENG Xiaohua, LIU Zhong, YIN Shimeng,et al. Departmentof Radiology, Wuhan General Hospital of Guangzhou Military Region, Wuhan, Hubei Province430070, P.R.China

【Abstract】 Objective To study the pathologicbases of the angiographic findings of endocardial cushion defects (ECD), and to analyzethe factors causing missed-diagnosis and misdiagnosis by comparing angiographic findingswith pathologic results in 18 cases with ECD, and to evaluate left ventriclar angiographyin diagnosing ECD. Materials and Methods Left ventriclar angiography in P-A positionwas performed in all 18 patients, with additional lateral angiography in 6 cases. All 18cases underwent surgery. The angiographic diagnosis was compared with the surgicalresults. Results Relying on the angiographic findings, the following diagnoses weremade: partial ECD (n=12), whole ECD (n=2), left ventricle to right atrium channel (n=2),tetralogy of Fallot (n=1) and Ebstein's anomaly of tricuspid valve (n=1). Surgical resultsconfirmed ECD in all 18 cases, of which 11 cases were of partial type, 2 were of wholetype and 5 were of single atrium type. Angiographic diagnosis agreed with the pathologicresults in 8 cases (44%). With angiography, typing mistakes occurred in 6 cases,missed-diagnosis in 1 and misdiagnosis in 3. Conclusion Left ventricular angiographyis an important pre-operative examination for revealing ECD. ECD carries some certaincharacteristic signs on angiography. However, other imaging modalities are needed when notypical angiographic signs can be demonstrated or when other cardiovescular abnormalitiesare possibly accompanied.

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