目 的 研究超声心动图 (Echocardiography，Echo)与多层螺旋 CT(Multi-slice computed tomography， MSCTA)诊断儿童复杂性先天性心脏病的临 床价值。方法 选取我院79例经病理证实 为复杂性先天性心脏病的患儿为研究对 象，均同时接受MSCTA、Echo诊断，比较 两种检测方式检出、漏诊、误诊率，并 与病理诊断结果比较，计算灵敏度及假 阴性率。结果 45例心内结构异常患者， MSCTA共检测出29例，漏诊16例，Echo检 出42例，漏诊3例。208例心外结构异常者 MSCTA检出195例，漏诊10例，误诊3例， Echo检出137例，漏诊60例，误诊11例， 漏诊最多类型为肺动脉异常增宽及右位主 动脉弓，分别18处、15处；MSCTA诊断心 内结构异常灵敏度为64.44%，假阴性率 35.55%，Echo诊断心内结构异常灵敏度 为93.33%，假阴性率6.67%，Echo灵敏度 显著高于MSCTA(P＜0.05)；MSCTA诊断心 外结构异常灵敏度为93.75%，假阴性率 6.25%，Echo诊断心外结构异常灵敏度为 65.87%，假阴性率34.13%，MSCTA灵敏度 显著高于Echo(P＜0.05)。结论 超声心动 图与CT技术均为诊断儿童复杂性先天性心 脏病的有效方式，超声心动图检测心内结 构异常灵敏度较高，但诊断心外结构异常 准确度低于64层螺旋CT，因此建议两者联 合以提高儿童复杂性先天性心脏病的检出 率。

Objective To study the clinical value of echocardiography (Echo) and multi-slice spiral CT (MSCTA) in the diagnosis of complex congenital heart disease in children. Methods Seventy-nine cases of children with pathologically confirmed complex congenital heart disease in the hospital were selected as the research object who received MSCTA and Echo diagnosis at the same time. The rates of detection, missed diagnosis and misdiagnosis of two kinds of detection methods were compared with pathologic diagnosis results. The sensitivity and false negative rate were calculated. Results Among the 45 patients with abnormalities of intracardiac structure, there were 29 cases of patients detected by MSCTA, 16 cases of missed diagnosis (aortic regurgitation in 5 parts, single atrium in 3 parts, patent foramen ovale in 1 part, pulmonary atresia in 2 parts and atrioventricular valve regurgitation in 5 parts). There were 42 cases detected by Echo with 3 cases of missed diagnosis (single atrium in 2 parts, patent foramen ovale in 1 part). Among the 208 cases of abnormality outside the heart, there were 195 cases detected by MSCTA with 10 cases missed diagnosis and 3 cases of misdiagnosis; There were 137 cases detected by Echo among whom there were 60 cases of missed diagnosis and 11 cases of misdiagnosis. Most of the types of missed diagnosis were pulmonary artery abnormal broadening and right-sided aortic arch which were respectively in 18 and 15 parts; For MSCTA diagnosis, the sensitivity of abnormalities of intracardiac structure was 64.44% and the false negative rate was 35.55% while for Echo diagnosis respectively were 93.33% and 6.67%. The sensitivity of Echo was significantly higher than that of MSCTA (P<0.05). The sensitivity of MSCTA in diagnosis of abnormality of extracardiac structure was 93.75% and false negative rate was 6.25% whle of Echo diagnosis respectively were 65.87% and 34.13%. The sensitivity of MSCTA was significantly higher than that of Echo (P<0.05). Conclusion Echocardiography and CT were effective ways to diagnose complex congenital heart disease in children. The sensitivity of echocardiography in detecting abnormalities of intracardiac structure is higher, but the accuracy of detecting abnormalities of extracardiac structure is lower than that of 64 slice spiral CT. It is recommended that the two combined to improve the detection rate of complex congenital heart disease in children.