目的 分析复杂性先天性心脏病 (CCHD)应用CT血管造影(CTA)及超声心动 图(UCG)两种影像方法诊断的效果。方法 收集我院近两年(2016年2月-2018年2月) 诊治的56名CCHD患者的术前冠脉CTA及UCG 检查影像资料，以手术结果为参照，比 较两种影像检查方法的准确性。结果 手 术发现心脏畸形共处132(心内61处＋心外 71处)，术前冠脉CTA检查及UCG检查总的 准确性分别为93.94%、87.12%，二者之间 无明显差异(P>0.05)；冠脉CTA及UCG检查 诊断心内畸形的准确性分别为90.16%、 86.89%，二者之间无显著差异(P>0.05)； 冠脉CTA及UCG检查诊断心外畸形的准确性 分别为97.18%、87.32%，冠脉CTA检查的 准确率显著优于UCG(P<0.05)。冠脉CTA及 UCG图像均可显示患者心脏内部及外部大 血管的位置、走行、结构、形态等解剖结 构异常，冠脉CTA图像能更直观显示患者 大血管畸形，UCG图像能更清晰显示患者 心内畸形。结论 CTA及UCG检查在CCHD疾 病中的总检出率无显著差异，但CTA检查 更易于观察心脏外部结构，UCG检查能更 清晰显示心脏内部畸形，二者联合诊断价 值更高。

Objective To analyze the effects of two imaging methods of CT angiography (CTA) and ultrasonic cardiogram (UCG) in the diagnosis of complex congenital heart disease (CCHD). Methods The imaging data of preoperative coronary CTA and UCG of 56 CCHD patients who were treated in our hospital in the past two years (February 2016 to February 2018) were collected. The surgical results were used as reference to compare the accuracy of the two imaging methods. Results Surgery found that there were 132 heart malformations (61 cases of intracardiac malformations and 71 cases of extracardiac malformations), and the total accuracies of preoperative coronary CTA and UCG were 93.94% and 87.12%, respectively (P>0.05). The accuracies of coronary CTA and UCG in the diagnosis of intracardiac malformation were 90.16% and 86.89% respectively (P>0.05). The accuracies of coronary CTA and UCG in the diagnosis of extracardiac malformation were 97.18% and 87.32% respectively, and the accuracy of coronary CTA was significantly higher than that of UCG (P<0.05). Coronary CTA and UCG images could show the location, shape, structure, morphology and other anatomical abnormalities of internal and external large blood vessels in the heart, and the coronary CTA images could show the large vascular malformations more clearly, and the UCG images could show the intracardiac malformations more clearly. Conclusion There is no significant difference in the total detection rate of CTA and UCG in CCHD disease. However, CTA is easier to observe the external structure of heart, and UCG can clearly show the internal malformations of heart, and the combined two has high diagnostic value.