【摘要】 目的研究16层螺旋CT血管造影(MSCTA)及其三维重建在先天性心脏病(简称先心病)肺静脉异位引流中的应用价值。方法对12例手术证实的异位引流肺静脉干38支进行分析,所有病例均行MSCT增强扫描,随后在工作站进行三维重建,并与12例经胸超声心动(TTE)及心血管造影(CAG)结果进行对比。结果手术证实异位引流肺静脉干38支,其中完全型异位引流肺静脉干32支,其中心上型24支、心内型8支,部分型异位引流肺静脉干6支,其中心上型3支、心内型3支。MSCTA、TTE、CAG诊断准确率分别为100%、81.6%、97.4%,MSCTA及CAG诊断准确率与TTE诊断准确率有显著性差异(χ2=7.71,P<0.01)、(χ2=5.03,P<0.05),MSCTA与CAG诊断准确率无显著性差异(χ2=1.01,P>0.05)。结论MSCTA及其三维重建对先心病异位引流肺静脉诊断与CAG诊断无显著性差异,是一种很好的无创检查方法。更多还原

【Abstract】 Objective To study the value of 16-slice helical CT angiography(MSCTA)and three-dimensional(3D)reconstructions in diagnosis of anomalous pulmonary venous drainage(APVD)in patients with congenital heart disease(CHD).Methods 38 segments of pulmonary vein of anomalous drainage in 12 patients confirmed by surgery were analysed.All patients were examined with contrast-enhanced multi-slice helical CT and subsequent 3D reconstruction at workstation.Correlative the CT features were analysed in comparison with transthoracic echocardiography(TTE)and cardioangiography(CAG).Results Of 38 pulmonary veins of anomalous drainage,32 segments were total anomalous drainage,including supracardia type(n=24)and cardiac type(n=8).6 segments of pulmonary vein were partial anomalous drainage,including supracardia type(n=3)and cardiac type(n=3).The accurate rate in diagnosis of APVD with MSCTA,TTE and CAG were 100%,81.6% and 97.4% respectively.MSCTA and CAG were superior to TTE in the identification of APVD(χ2=7.71,P<0.01),(χ2=5.03,P<0.05),the diagnostic accuracy of MSCTA and CAG showed no difference(χ2=1.01,P>0.05).Conclusion MSCTA with 3D and CAG in evaluating APVD are no difference,MSCTA is a good noninvasive diagnostic tool in preoperative evaluation and selecting operative modalities for APVD.更多还原