64层螺旋CT在新生儿及婴儿先天性心脏病诊断中的应用-东南大学学报医学版

64层螺旋CT在新生儿及婴儿先天性心脏病诊断中的应用

单位：1. 东南大学附属中大医院儿科, 江苏南京 210009;
2. 东南大学附属中大医院放射科, 江苏南京 210009

分类号：R541.1; R814.42; R816.2; R816.92

出版年·卷·期（页码）：2009·28·第三期（212-216）

摘要：

目的: 探讨64层螺旋CT对新生儿及婴儿先天性心脏病(CHD)的诊断价值。方法: 对55例诊断CHD的新生儿及婴儿进行64层螺旋CT对比增强心脏检查,并用多平面重建、最大密度投影及容积成像进行图像重建。所有病例均做超声心动图(ECG)对照,并经手术证实。结果: 64层螺旋CT、ECG对心血管畸形的诊断准确率分别为96.98%、71.86%,前者诊断准确率明显高于后者(χ²=23.88,P<0.005)。心内畸形68处中,64层螺旋CT、ECG的诊断准确率分别为92.65%、97.06%,两者无统计学差异(χ²=0.68,P>0.05)。心外畸形131处中,64层螺旋CT、ECG的诊断准确率分别为99.24%、58.78%,前者诊断准确率明显高于后者(χ²=32.32,P<0.005)。结论: 64层螺旋CT是诊断CHD可靠的方法,弥补了ECG对心外畸形诊断的不足,尤其能评价主动脉、肺动脉以及冠状动脉,对术前手术方案的制定具有重要价值。

Objective To explore the clinical application of 64-slice spiral CT in diagnosing congenital heart disease (CHD) of neonates and infants.Methods 55 neonates and infants with diagnosed CHD underwent cardiac CT angiography with 64-slice CT.Multi plannar reformation,maximum intensity projection and volume render were used to reconstruct image.Echocardiography(ECG) and operation were performed for all patients.Results The accuracy of 64-slice CT and ECG in detecting deformities of CHD were 96.98%,71.86% respectively.64-slice CT was superior to ECG in detecting deformities of CHD (χ²=23.88,P <0.005).In 68 intra cardiac deformities,the accuracy of 64-slice CT and ECG were 92.65%,97.06% respectively.64-slice CT was as accurate as ECG in revealing intra cardiac deformities (χ²=0.68, P >0.05).In 131 extra cardiac anomalies,the accuracy of 64-slice CT and ECG were 99.24%,58.78% respectively.64-slice CT was superior to ECG in identifying extra cardiac deformities (χ²=32.32,P<0.005).Conclusion 64-slice CT is credible technique for diagnosing CHD.It fetches up the shortage of ECG to diagnosis extra cardiac deformities.With its evaluation of aortic artery,pulmonary artery and coronary anomalies,64-slice CT is extremely valuable for planning the operative procedure on the patients with CHD.

参考文献：

[1] 张郁林,程沛,王冲,等.婴儿先天性心脏病的外科治疗[J].东南大学学报:医学版,2005, 24(5):318-320.
[2] MERTENS L,GANAME J,EYSKENS B.What is new in pediatric cardiac imaging?[J].Eur J Pediatr,2008,167(1):1-8.
[3] NIKOLAOU K,FLOHR T,KNEZ A,et al.Advances in cardiac imaging:64 slice scanner[J].Int J Cardiovasc Imaging,2004,20(6):535-540.
[4] WILLIAMS B J,MULVIHILL D M,PETTUS B J,et al.Pediatric superior vena cava syndrome:assessment at low radiation dose 64-slice CT angiography[J].J Thorac Imaging,2006,21(1):71-72.
[5] SIEGEL M J.Multiplanar and three-dimensional multi-detector row CT of thoracic vessels and airways in the pediatric population[J].Radiology,2003,229(3):641-650.
[6] YANG D H,GOO H W,SEO D M,et al.Multi slice CT angiography of interrupted aortic arch[J].Pediatr Radiol,2008,38(1):89-100.
[7] LAURENS F T,SUBRAMANIAM C K,JOANNE D S,et al.Noncoronary applications of cardiac multi detector row computed tomography[J].JACC Cardiovascular Imaging,2008,1(1):94-106.
[8] KHOSITSETH A,PORNKUL R,SIRIPORNPITAK S.Diagnosis of tetralogy of Fallot with anatomically corrected malposition of the great arteries and single coronary artery by multi detector CT[J].Br J Radiol,2006,79(943):e5-7.
[9] SUN Z,LIN C,DAVIDSON R,et al.Diagnostic value of 64-slice CT angiography in coronary artery disease:a systematic review[J].Eur J Radiol,2008,67(1):78-84.
[10] LEY S,ZAPOROZHAN J,ARNOLD R,et al.Preoperative assessment and follow-up of congenital abnormalities of the pulmonary arteries using CT and MRI[J].Eur Radiol,2007,17(1):151-162.

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