The value of echocardiography in the diagnosis of persistent fifth aortic arch and its classification / 中华超声影像学杂志

Objective:To study the classification of persistent fifth aortic arch (PFAA) and the value of echocardiography in the diagnosis of PFAA.Methods:A total of 16 cases (male 6, female 10, at ages from 7 days to 4 years and 2 months old, the median age was 3 months) diagnosed with PFAA in Beijing Children′s Hospital Affiliated to Capital Medical University from January 2013 to June 2019 were studied retrospectively. The diagnosis standard, differential methods and misdiagnosed analysis of different subtypes of PFAA by echocardiography were summarized and analyzed.Results:The 16 cases included 1 case of type A1 double lumen aortic arch, 8 cases of type A2 single-lumen aortic arch, 3 cases of type B1 with pulmonary atresia and 4 cases of type B3 pulmonary artery branch arising from the distal end of ascending aorta. Only one patient of double lumen aortic arch missed diagnosis by echocardiography, and the rest were accurately diagnosed by echocardiography. CTA was performed in 13 cases, including 9 cases of type A, 1 case of type B1 and 3 cases of type B3, which confirmed the echocardiography diagnosis. Seven cases of Type A2 were operated.Conclusions:PFAA is a rare and complicated aortic arch malformation, which is divided into four major classification and multiple subtypes. Echocardiography can diagnose the PFAA and its classification, it is of great clinical significance for the early diagnosis, treatment and prognosis of children.

Diagnosis and follow-up of patients with Kawasaki disease complicating coronary aneurysms by echocardiography: experience of 338 cases from a single center / 中华超声影像学杂志

Objective To investigate the diagnosis and prognosis of patients with coronary artery aneurysm in Kawasaki disease.Methods The data of ultrasonic diagnosis and follow-up of 338 children with Kawasaki disease complicated with coronary artery aneurysms were analyzed.Results The incidence of coronary artery aneurysm in the acute stage of Kawasaki disease was 21.2％ (338/1 594).Of all the 338 cases,small aneurysms was 66.6％ (225 cases),medium aneurysms was 25.1％ (85 cases),and giant aneurysms was 8.3％ (28 cases).There were 719 branches involved in 338 cases,32.8％ of them in left main coronary artery and 31.1％ in right coronary artery;25.3％ in left anterior descending branch,and 10.8％ in left circumflex branch.A total of 382 branches were followed up,including 218 branches of small coronary aneurysm group and 82.1％ of them were completely recovered to the normal diameter.The medium aneurysm group was 124 brunches,the proportion of no significant change,retraction,and normal were 23.4％,68.5％ and 8.1％,respectively.There were 40 brunches in the giant anuerysm group,in which the proportion of no significant change,retraction,and normal were 70.0％,27.5％ and 2.5％,respectively.A total of 30 thrombosiswere detected by echocardiography in the acute stage,20 thrombosis were regularly followed up,12 thrombosis gradually subsided,and the other remained persist.Five thrombosis were detected in the sequelae stage,and all located in the giant coronary aneurysm.Seven children were clinically diagnosed with ischemic heart disease,of them,acute myocardial infarction in 1 case,1 died of heart failure.Conclusions Kawasaki disease coronary artery disease are common in small coronary aneurysms,of which the left main artery and right coronary artery lesions are the most common,and the prognosis is better;medium and giant aneurysm need more time to recovery,and are easy to complicated with thrombosis.

Etiology and echocardiographic analysis of large amount of pericardial effusion in children / 中华实用儿科临床杂志

Objective To investigate the value of echocardiography application in the diagnosis of large amount of pericardial effusion (PE) in children by retrospective etiology and prognostic analysis.Methods A total of 68 children with large amount of PE admitted in Beijing Children's Hospital,Capital Medical University from March 2010 to March 2016 were reviewed retrospectively,and the echocardiographic presentations,etiology diagnosis,treatment,and prognosis were analyzed.Results Analysis indicated that the etiology diagnosis ratio was 97.1％ (66/68 cases),the effective ratio of the medical treatment was 71.8％ (46/64 cases),and the mortality rate was 7.8％ (5/64 cases).The morbidity was ranked from high to low as follow:large amount of PE included infectious pericarditis 27 cases,tumor associated PE 14 cases,postpericardiotomy syndrome and cardiotrauma 14 cases,systemic diseases 6 cases,vasa lymphatic related diseases 5 cases and idiopathic PE 2 cases.PE resulted from tumor associated PE and vasa lymphatic diseases had lower cure rate than the overall cure rate,and there were statistical significance (28.6％ vs.71.8％,x2 =9.092,P =0.003;20.0％ vs.71.8％,x2 =5.059,P =0.018).Thirty-five children received pericardiocentesis or fenestration drainage.Chylopericardium was restricted to vasa lymphatic diseases.All tumor associated PE had the hemorrhagic PE.The strong echo point in the pericardial cavity might indicate implication for hemorrhagic PE (x2 =5.166,P =0.023).The abnormal mass detected by echocardiography might indicate the tumor related or infectious causes.Conclusions The etiology of large amount of PE could be determined in most of children.As the preferred diagnosis method,echocardiography could help etiological diagnosis combined with clinical manifestation.

Echocardiographic and clinical retrospective study of 35 patients with Kawasaki disease combined with coronary artery thrombosis / 中华实用儿科临床杂志

Objective To summarize the echocardiographic findings and clinical characteristics of Kawasaki disease(KD) complicated with coronary artery thrombosis (CAT).Methods Thirty-five patients with KD combined with CAT were enrolled,who were admitted to Beijing Children's Hospital,Capital Medical University between July 2005 and August 2016.The clinical characteristics and echocardiographic findings during follow-ups were retrospectively studied.According to whether the childrenhad been complicated with myocardial ischemia,the patients were divided into 2 groups:ischemic group and non-ischemic group.The duration of fever,the time when the intravenous immunoglobulin(IVIG) was first injected,the time when coronary artery aneurysms (CAA) was formed,the maximum diameter of CAA and inflammatory index inthe acute phase were compared between 2 groups.Results All of the 35 children diagnosed as KD combined with CAT suffered firom CAA,and the coronary thrombosis was detected in all the cases with aneurysms.Thirty-five patients had 99 branches of CAA,of which the maximum diameter of CAA was (9.6 ± 3.1) mm(4.0-19.0 mm).Fifty-four plots of CAT were detected in the aneurysms.The diameter of CAA that thrombosis located was larger than that of which the thrombosis was not located[(10.9 ± 2.8) mm vs.(7.9 ± 2.6) mm],and the difference was significant(P ＜0.01).During 4 months to 10 years and 8 months [(39.2 ±29.5) months] follow-ups,CAA regressed in 32 branches [32.3％ (32/99 branches)],of which 4 branches [4.0％ (4/99 branches)] completely regressed to the normal diameter.The maximum diameter of CAA regressed was smaller than the maximum diameter of CAA consistence [(7.3 ± 1.9) mm vs.(10.6 ± 3.0) mm],and the difference was significant (P ＜ 0.01).Out of 35 patients,15 cases [42.9％ (15/35 cases) had myocardial ischemia,while the other 20 cases[57.2％ (20/35 cases)] didn't have.Among 15 cases with myocardial ischemia,6 cases[17.1％ (6/35 cases)] had myocardial infarction,4 cases [11.4％ (4/35 cases)] had heart failure,and 1 case[2.9％ (1/35 cases)] died of acute heart failure complicated with severe ventricular arrhythmia.Compared with non-ischemic group,the children in the ischemic group had longer duration of fever[(19.1 ± 7.8) d vs.(12.1 ± 3.3) d],higher white blood cell account in the acute phase[(24.8 ± 13.5) × 1012/L vs.(19.7 ±4.0) × 1012/L],later treatment of IVIG [(13.9 ± 5.5) d vs.(9.8 ±3.8) d],and earlier CAA formation [(16.0 ±4.9) d vs.(20.9 ± 14.5) d],and the differences were statistically significant (all P ＜ 0.05).Conclusions CAT of children with KD commonly originates from CAA.Patients who have more serious inflammatory reaction in the acute phase,earlier formation,heavy severity and longer consistence of CAA are prone to have myocardial ischemia.Echocardiographic study plays an important role in monitoring CAA,detecting the CAT and finding the early left ventricle dysfunction,which is of clinical significance.

Evaluation of Post-operative Complication in Patients With Total Anomalous Pulmonary Venous Connection by Echocardiography / 中国循环杂志

Objective: To evaluate the post-operative complication of pulmonary vein stenosis in patients with total anomalous pulmonary venous connection (TAPVC) by echocardiography. Methods: A total of 66 TAPVC pediatric patients with surgical repair in our hospital were retrospectively studied. The peri-operative and mid-term post-operative echocardiography was conducted to evaluate the complication of pulmonary vein stenosis. Results: The peri-operative and mid-term post-operative echocardiography presented the increased left ventricular diastolic end diameter (LVEDd) and decreased right ventricular diameter in all 66 patients, P0.05. Conclusion: Echocardiography may monitor the operative effect of TAPVC, the occurrence of post-operative pulmonary vein stenosis could be found by examining right ventricular diameter and pulmonary artery pressure in pediatric patients.

Anomalous origin of the left coronary artery from the pulmonary artery in infants: depiction by 64 multi-slice spiral CT / 中华放射学杂志

onary artery was turtuous and dilated in 4 cases. Conclusion 64 MSCT is emerging as an essential imaging tool for detecting early anomalous origin of the left coronary artery from the pulmonary artery with high resolution and significance.

The role of echocardiography in diagnosis and management of double aortic arch / 中华超声影像学杂志

Objective To evaluate the role of echocardiography in diagnosis and post-operative evaluation of infants and children with double aortic arch. Methods Echocardiography was performed in 6 patients with double aortic arch from January 2006 to June 2008. The outcome of postoperative follow-up was also evaluated. Results Six patients ranged in age from 3 months to 4 years and averaged 18 months. There were 2 boys and 4 girls. Echocardiography diagnosed double aortic arch in 4 patients, one balanced arch and 3 right arch dominant, and was confirmed by surgical observation in each patient. The size of the two arches were almost same in balanced arch,and the diameter of right arch was bigger than that of left arch in right arch dominant. Echocardiography failed to diagnose in 2 patients with balanced arch. Three patients had associated heart defect, such as patent ductus arteriosus and ventricular septal defect. Five of the 6 patients underwent surgical division of the left arch in order to relieve esophageal and tracheal compression. At about 2 years postoperative follow-up,echocardiography can clearly show the flow of aortic arch and it's branches. Conclusions It is an important clue to double aortic arch if only two branches of aortic arch was shown on supersternal view by echocardiography. As a non-invasive techniqe, echocardiography is useful for diagnosing and post-operative evaluating of patients with double aortic arch.

Cleaning Effect of Dentistry Handset by Three Purging Methods / 中华医院感染学杂志

OBJECTIVE To compare the cleaning effect of the dentistry high speed turbine wheel handset by the three purging methods,i.e.,manual,the entire automatic ultrasonic wave and the entire automatic hot cleaner/sterilizing machine.METHODS The Staphylococcus aureus was used to pollute dentistry handset,then the quota sterilization experiment was carried out.RESULTS 99.47%,99.80%,and 99.99% of the extinguishing rate were got by the manual,the ultrasonic wave cleaner and the entire automatic hot cleaner/sterilizing machine purging methods respectively,after the SPSS13.0 variance analysis,P