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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

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. 双源计算机断层摄影对先天性心脏病的诊断[J]. 协和医学杂志, 2011, 2(3): 200-204. doi: 10.3969/j.issn.1674-9081.2011.03.002
引用本文: 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. 双源计算机断层摄影对先天性心脏病的诊断[J]. 协和医学杂志, 2011, 2(3): 200-204. doi: 10.3969/j.issn.1674-9081.2011.03.002
Yi-ning WANG, Ling-yan KONG, Qi MIAO, Li-gang FANG, Shuo LI, Kang ZHOU, Zhi-wei WANG, Kai XU, Hong-ling FAN, Zheng-yu JIN. Dual-source Computed Tomography for the Diagnosis of Patients with Congenital Heart Disease[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(3): 200-204. doi: 10.3969/j.issn.1674-9081.2011.03.002
Citation: Yi-ning WANG, Ling-yan KONG, Qi MIAO, Li-gang FANG, Shuo LI, Kang ZHOU, Zhi-wei WANG, Kai XU, Hong-ling FAN, Zheng-yu JIN. Dual-source Computed Tomography for the Diagnosis of Patients with Congenital Heart Disease[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(3): 200-204. 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

doi: 10.3969/j.issn.1674-9081.2011.03.002
详细信息
    通讯作者:

    金征宇 电话:010-65295441, 电子邮件:jin_zhengyu@163.com

  • 中图分类号: R541.1;R445.3

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

More Information
  • 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。
  • 图  1  双源CT多平面重建图像示室间隔缺损和主动脉骑跨(黑箭头)

    Ao:主动脉; RV:右心室; LV:左心室;

    图  2  双源CT多平面重建图像示右室流出道狭窄(白箭头)

    图  3  双源CT容积再现图像示动脉导管未闭(白箭头)

    图  4  双源CT多平面重建图像示双上腔静脉

    RSVC:右上腔静脉; LSVC:左上腔静脉

    图  5  双源CT容积再现图像示右冠状动脉高位开口

    RCA:右冠状动脉; LAD:左前降支

    图  6  双源CT多平面重建图像示主肺动脉充盈缺损(白箭头)

    表  1  先心病患者双源CT与心脏超声诊断比较

    畸形类型 手术证实数 DSCT ECHO
    诊断数 误诊数 漏诊数 诊断数 误诊数 漏诊数
    心脏内部结构异常 41 37 4 37 4
      室间隔缺损 11 11 11
      房间隔缺损 8 8 7 1
      二尖瓣脱垂 1 1 1
      三尖瓣脱垂 1 1 1
      三尖瓣下移畸形 1 1 1
      三尖瓣闭锁 1 1 1
      肺动脉瓣二叶瓣 3 1 2 3
      肺动脉瓣狭窄 7 6 1 7
      右室流出道狭窄 8 8 8
    心脏-大血管连接异常 9 9 8 1 1
      主动脉骑跨 6 6 6
      大动脉转位 1 1 1
      右室双出口 1 1 1
      肺静脉畸形引流 1 1 1 1
    大血管异常 13 13 10 2 3
      动脉导管未闭 5 5 5
      肺动脉狭窄 4 4 4 1
      永存左上腔静脉 1 1 1 1
      冠状动脉变异 2 2 2
      冠状动脉瘘 1 1 1
    总计 63 59 55 3 8
    DSCT:双源计算机断层摄影; ECHO:心脏超声
    下载: 导出CSV

    表  2  先心病患者双源CT与心脏超声诊断敏感性比较[n (%) ]

    检查方法 心脏内部结构异常 心脏-大血管连接异常 大血管异常 总计
    ECHO 37/41 (90. 2) 8/9 (88. 9) 10/13 (76. 9) 55/63 (87. 3)
    DSCT 37/41 (90. 2) 9/9 (100. 0) 13/13 (100. 0) 59/63 (93. 7)
    χ2 - - - 1.474
    P 1. 000 1. 000 0. 220 0. 225
    DSCT、ECHO:同表 1
    下载: 导出CSV
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出版历程
  • 收稿日期:  2011-05-18
  • 刊出日期:  2011-07-30

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