双源计算机断层摄影对先天性心脏病的诊断

王怡宁; 孔令燕; 苗齐; 方理刚; 李烁; 周慷; 王志伟; 徐凯; 樊红苓; 金征宇

doi:10.3969/j.issn.1674-9081.2011.03.002

双源计算机断层摄影对先天性心脏病的诊断

Dual-source Computed Tomography for the Diagnosis of Patients with Congenital Heart Disease

摘要

摘要:
目的探讨双源计算机断层摄影(dual-source computed tomography, DSCT)诊断先天性心脏病(先心病)的临床应用价值。
方法 DSCT增强扫描检查先心病患者20例, 年龄4个月~53岁, 平均19岁; 所有病例均以心脏超声(echocardiography, ECHO)为对照, 并经手术证实。
结果 20例患者经手术证实的心内外结构畸形共63处, DSCT检出59处, 诊断敏感性为93.7%;ECHO检出55处, 诊断敏感性87.3%, 两种方法诊断敏感性比较差异无统计学意义(χ²=1.474, P=0.225)。63处结构畸形中, 心脏部分畸形41处, DSCT检出37处(90.2%), ECHO检出37处(90.2%), 两者敏感性相当(P=1.000);心脏-大血管连接处畸形9处, DSCT检出9处(100%), ECHO检出8处(88.9%), 差异无统计学意义(P > 0.05);大血管部分畸形13处, DSCT检出13处(100%), ECHO检出10处(76.9%), 差异无统计学意义(P > 0.05)。
结论 DSCT能够显示心内外结构畸形, 具有较高的诊断敏感性, 对先天性心脏病, 特别是合并心外大血管畸形的诊断有重要价值。

Abstract:
Objective To evaluate the value of dual-source computed tomography (DSCT) in the diagnosis of congenital heart disease.
Methods Twenty patients aged 4 months to 53 years (mean age 19 years) with congenital heart disease underwent contrast-enhanced DSCT. The results were compared with those of echocardiography (ECHO) and confirmed by surgery.
Results Among the 20 patients, DSCT detected 59 of 63 (93.7%) anomalies that confirmed by surgery, and ECHO detected 55 of 63 (87.3%) (χ²=1.474, P=0.225). In the 41 intracardiac anomalies, DSCT was as sensitive as ECHO (both 90.2%, P=1.000). In the 9 heart-vessel conjunction deformities, no significant difference was found between the sensitivities of two modalities (100% vs. 88.9%, P > 0.05). In the 13 great vessel deformities, no significant difference was found between the sensitivities of two modalities (100% vs. 76.9%, P > 0.05).
Conclusion DSCT detects intra- and extra-cardiac anomalies with high sensitivity and has an important value in the diagnosis of congenital heart disease especially those with extra-cardiac anomoalies.

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