冠状动脉异常起源于肺动脉一例

doi:10.3877/cma.j.issn.1672-6448.2019.04.016

中华医学超声杂志（电子版） ›› 2019, Vol. 16 ›› Issue (04) : 317 -319. doi: 10.3877/cma.j.issn.1672-6448.2019.04.016

所属专题：经典病例；文献；

病例报告

冠状动脉异常起源于肺动脉一例

汪柳玉¹, 何亚峰¹, 马小静¹^,^†(

), 徐中华¹

^1. 430022　武汉亚洲心脏病医院超声科

收稿日期:2018-08-01 出版日期:2019-04-01
通信作者: 马小静

A case of coronary artery abnormality arising from the pulmonary artery

Liuyu Wang¹, Yafeng He¹, Xiaojing Ma¹()

Received:2018-08-01 Published:2019-04-01
Corresponding author: Xiaojing Ma

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图1 右冠状动脉起自右冠窦超声声像图。图a为胸骨旁左心长轴切面常规二维超声图像，显示扩张的右冠状动脉起自右冠窦（白色箭头所示）；图b为胸骨旁左心长轴切面彩色多普勒图像，显示右冠状动脉血流信号增强；图c为大动脉短轴切面彩色多普勒图像，显示右冠状动脉血流信号增强，易被误诊为室间隔缺损

图2 左冠状动脉异常起源于肺动脉超声声像图。图a为左冠状动脉起始处切面图（左图为常规二维超声图像，右图为彩色多普勒图像），显示左冠窦处见一血管结构与左冠窦相通，疑似左冠状动脉起始（白色箭头所示）；图b为彩色多普勒超声显示左冠窦处所见血管结构腔内血流方向为蓝色（白色箭头所示）；图c为左冠状动脉起自肺动脉左侧壁（白色箭头所示，左图为常规二维超声图像，右图为彩色多普勒图像）；图d为彩色多普勒超声显示肺动脉蓝色血流进入左冠状动脉；图e为彩色多普勒超声显示左冠状动脉红色血流进入肺动脉；图f为脉冲多普勒显示左冠状动脉内的连续性正向血流信号，并可见负向血流信号

图3 室间隔长轴和短轴非标准切面超声图像。图a为室间隔长轴非标准切面彩色多普勒图像，显示室间隔及右心室心肌内丰富的冠状动脉侧支循环血流（白色箭头所示）；图b为室间隔短轴非标准切面彩色多普勒图像，显示室间隔内丰富的冠状动脉侧支循环血流（白色箭头所示）；图c为脉冲多普勒显示室间隔内冠状动脉分支的连续性血流信号

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