目的 探讨CT血管成像(CTA)在先 天性心脏病(CHD)伴内脏异位患者中的临 床诊断价值。方法 回顾性分析2012年1 月-2017年5月在我院接受治疗的64例CHD 合并内脏异位患者的临床资料，入选前均 经过手术及病理学证实，术前均行超声心 动图、CTA检查。通过观察心室发育与异 构类型、肺动脉和肺叶的发育、大动脉的 位置关系、肝脏、胃腔在腹腔的位置及脾 脏数目等确定CHD类型和内脏异位情况， 并将CTA诊断结果与手术结果、心脏超声 结果进行比较。结果 以手术结果为标 准，CHD类型方面，CTA、超声诊断准确率 分别为90.63%(58/64)、76.56%(49/64)， 差异有统计学意义(P＜0.05)；内脏异 位方面，CTA、超声诊断准确率分别为 91.35%(61/64)、79.69%(51/64)，差异有 统计学意义(P＜0.05)；且CTA诊断内脏异 位情况与手术结果相比差异无统计学意 义(P＞0.05)。结论 CTA可很好地显示心 脏、大血管及胸腹腔内结构，对CHD伴内 脏异位的临床诊断效果优于超声，对患者 病情评估及手术方案制定有较高的应用价 值。

Objective To discuss the clinical value of CT angiography (CTA) in the diagnosis of congenital heart disease (CHD) with heterotaxis. Methods The clinical data of 64 patients with CHD complicated with heterotaxy treated in the hospital from January 2012 to May 2017 were analyzed retrospectively. The patients were selected after being confirmed by surgery and pathology, and they were examined with echocardiography and CTA. The type of CHD and the situation of heterotaxis were determined through observation of the ventricular development and heterogeneous type, the development of pulmonary artery and lung lobe, the aortic positional relationship, the locations of liver and gastral cavity in abdominal cavity and the number of spleen. The results of CTA were compared with those of surgery and echocardiography. Results With surgical results as the standard, the accurate rates of CTA and ultrasound in the diagnosis of the type of CHD were 90.63% (58/64) and 76.56% (49/64), respectively (P<0.05). The accurate rates of CTA and ultrasound in the diagnosis of heterotaxy were 91.35% (61/64) and 79.69% (51/64), respectively (P<0.05). There was no significant difference between CTA and surgery in the diagnosis of heterotaxy (P>0.05). Conclusion CTA can well display the structures of the heart, large vessels, thorax and abdomen. The clinical diagnosis of CHD and heterotaxy with CTA is superior to ultrasound. It is of great value in the evaluation of patient's condition and the development of the surgical plan.