【摘要】 目的探讨双源CT在先天性心脏病诊断中的应用价值。方法采用西门子Siemens Somatom Definition DSCT增强扫描检查先天性心脏病50例,其中40例采用心电门控扫描模式,10例因心率过快采用普通胸部增强扫描模式。50例均行心脏超声检查,其中27例经手术证实、9例经X线心血管造影证实。本组以手术或X线心血管造影结果为标准,比较双源CT和心脏超声的诊断准确率。结果经手术或X线心血管造影证实的36例先天性心脏病中,含单纯房间隔缺损、单纯室间隔缺损、主动脉弓离断、单心室、完全型大动脉错位、肺动脉起源异常、冠状窦无顶综合征各1例,单纯动脉导管未闭、校正型大动脉错位、冠状动脉起源异常、肺动脉闭锁并室间隔缺损、左室双出口各2例,右室双出口4例,主动脉缩窄5例,法洛四联症10例。36例共计107处畸形,均以手术或X线心血管造影结果证实,其中心内畸形30处,双源CT和心脏超声诊断准确率分别为93.33%和96.67%(P=1.000)。心外畸形77处,双源CT和心脏超声诊断准确率分别为96.10%和87.01%,双源CT诊断准确率高于心脏超声(χ2=4.117,P=0.042)。双源CT与心脏超声联合诊断准确率为99.21%。结论双源CT对比增强扫描对先天性心脏病心外畸形的诊断准确率高于心脏超声,但二者联合可提高对先天性心脏病的诊断准确率。更多还原

【Abstract】 Objective To explore the clinical value of dual source CT in diagnosis of congenital heart diseases. Methods 50 patients with suspected congenital heart disease underwent contrast-enhanced dual source CT. Echocardiograph-gated technology was used in 40 patients,and common chest technology was used in 10 patients because of sinus tachycardia. All 50 patients underwent echocardiography,27 of them were confirmed by surgical operations and 9 of them were confirmed by X-ray angiography. Surgical or X-ray angiography was used as a reference standard. Findings were compared with that of echocardiography in 36 patients. Results Of the 36 patients with congenital heart diseases,1 arterial septal defect,1 ventricular septal defect,1 interruption of the aortic arch,1 single ventricle,1 complete transposition of the great artery,1 abnormal origin of the pulmonary artery,1 abnormal coronary sinus,2 patent ductus arteriosus,2 corrected transposition of the great arteries,2 double outlet left ventricle,2 abnormal origin of the right coronary artery,2 pulmonary atresia with ventricular septal defect,4 double outlet left ventricle,5 coarctation of the aorta and 10 Tetralogy of Fallot. 107 deformities were confirmed by surgical or X-ray angiography in 36 patients. The accuracy of dual source CT in detecting cardiac deformities was 95.33%. In 30 intra-cardiac deformities,definite diagnostic rates of dual source CT and echocardiography were 93.33% and 96.67%,and dual source CT was as accurate as echocardiography in revealing intracardiac deformities(P=1.000). In 77 extracardiac anomalies,definite diagnostic rates of dual source CT and echocardiography were 96.10% and 87.01%,and dual source CT was superior to echocardiography in identifying extracardiac anomalies(χ2=4.117,P=0.042). Combination of dual source CT and echocardiography increased the definite diagnostic rate to 99.21%. Conclusion Dual source CT is superior to echocardiography in identifying extra-cardiac anomalies. Their combination can improve definite diagnostic rate for congenital heart disease.更多还原