论著-头颈部
双源螺旋CT在婴幼儿紫绀型复杂先天性心脏病诊断的应用价值
作者:石 磊 翟 波 杨 房 董向阳 陈振良
所属单位:郑州大学附属儿童医院、河南省儿童医院、郑州儿童医院(河南 郑州 450018)
PDF摘要
目的探讨双源螺旋CT(DSCT)在 婴幼儿紫绀型复杂先天性心脏病(CCHD) 诊断的应用价值。方法 回顾性分析我院 106例婴幼儿紫绀型CCHD患者临床资料, 患者均行DSCT、经胸超声心动图(TTE) 检查。比较两种检查手段对心内畸形检 出率的差异,并分析其对肺动脉直径、 左心室功能指标的诊断情况。结果 DSCT 检查对心内畸形检出率为89.3%稍低于 TTE检查91.8%,其漏诊率10.7%稍高于 TTE检查8.2%,比较无统计学差异(P> 0.05);DSCT检查对肺动脉直径诊断准确 性高于TTE检查,比较具有统计学差异(P <0.05);DSCT检查测得EDV、ESV、SV稍 高于TTE检查,比较无统计学差异(P> 0.05)。结论 DSCT对婴幼儿紫绀型CCHD 诊断效果佳,对心内、心外畸形诊断价 值较高,准确反映左心室功能水平,值 得临床选择。
Objective To explore the value of dual-source spiral CT (DSCT) in the diagnosis of cyanotic complicated congenital heart disease (CCHD) in infants. Methods Retrospective analysis of 106 cases of infants with cyanotic CCHD patients with clinical data, patients were underwent DSCT, transthoracic echocardiography (TTE). The difference of the detection rate of intracardiac malformation was compared between the two methods, and the diagnosis of pulmonary artery diameter and left ventricular function was analyzed. Results The detection rate of intracardiac malformation was 89.3%, which was slightly lower than that of TTE (91.8%). The missed rate was 10.7%, which was slightly higher than that of TTE (8.2%). There was no significant difference (P>0.05). DSCT examination of pulmonary artery diameter diagnosis accuracy than TTE examination, compared with a statistical difference (P<0.05). There was no significant difference in EDV, ESV and SV between DSCT and TTE (P>0.05). Conclusion DSCT is effective in the diagnosis of cyanotic CCHD in infants.It is valuable for the diagnosis of intracardiac and extracardiac malformations, which accurately reflects the level of left ventricular function and is worthy of clinical choice.
【关键词】双源螺旋CT;婴幼儿;紫绀型;复杂先天性心脏病;诊断价值
【中图分类号】R174;541.4
【文献标识码】A
【DOI】10.3969/j.issn.16720-5131.2018.08.020
前言
先天性心脏病是临床上婴幼儿较为常见的先天性疾病之一,其发 病率较高,每年新增先天性心脏病患儿约15万[1-3],CCHD患儿心脏、心 外血管可同时受累,表现为缺如或异常连接,可引起缺血、缺氧、心 力衰竭等,病死率也较高。早期诊断、早期干预对CCHD患儿预后具有 重要价值,以往TTE检查常用于CCHD患儿术前、术后病情评估[4-5],对 瓣膜狭窄、腱索发育不良等心内畸形检出率较高,而对心外血管诊断 效果常不佳。双源螺旋CT技术具有较高的时间分辨率,对成人心脏疾 病诊断敏感性较高,但其在婴幼儿紫绀型CCHD研究报道则较少。本研 究探讨DSCT在婴幼儿紫绀型CCHD诊断中的应用,现汇报如下。
中国CT和MRI杂志
第16卷, 第 8 期
2018年08月
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