در تشخيص بازماندن مجراي شرياني در كودكان M-Mode مقايسه اكوكارديوگرافي داپلر و

Comparison between M-Mode and Doppler echocardiography in diagnosis of patent ductus arteriosus in children

Introduction: Patent ductus arteriosus (PDA) is the persistence of a normal fetal structure between left pulmonary artery and descending aorta. Persistence of this fetal structure beyond 10 days of life is considered abnormal. In this study we compared M-Mode and Doppler echocardiography in diagnosis of PDA in children at Aliasghar Ilospital in Zahedan and Children hospital in Bandar Abbas for one year. Methods: We selected 62 patients that were suspicious to have PDA on physical examination. It should be mentioned that we omitted patients with other congenital cardiac abnormalities such as truncus arteriosus, ASD, VSD and AVSD. Our patients were below 15 years old. Before echocardiography, physical examination, CXR and ECG were done for the patients. Then, they were evaluated with both M-Mode and Doppler Echocardiography and finally results were statistically analyzed. Results: Out of 62 patients, 34 were female and 28 were male. 51.6% patients were less than one year old and others were older. 85% of patients had cardiac murmur on physical examination and in 50% of them pulmonary component of second heart sound was increased. Peripheral pounding pulses were present in 85% of patients. In chest X-Ray, 82.3% of patients had increased cardiothoracic ratio and pulmonary vascular markings were increased in 85.5% of them. On ECG, 58.1% of patients had signs of right and left or bilateral ventricular hypertrophy. Pulmonary hypertension was also seen in 51.6% of patients. PDA was diagnosed with M-Mode echocardiography in 56 patients (90.3%) and with Doppler echocardiography in 61 patients (98.4%). According to McNemar statistical analysis, there was not an obvious difference between these two methods of echocardiography in PDA diagnosis (p-0.125). Conclusion: Findings of this study showed that M-Mode and Doppler echocardiography for diagnosis of PDA in children are similar and again attention to M-Mode echocardiography can he helpful in diagnosis of PDA in children especially restless infants and neonates.