【摘要】 目的 比较多层螺旋CT(MDCT)和心导管造影、经胸超声心动图(TTE)在术前评价肺动脉闭锁伴室间隔缺损的价值。方法 回顾分析116例手术证实的肺动脉闭锁伴室间隔缺损患者的临床和影像资料。比较MDCT,TTE和心导管检查评价肺固有动脉、体肺动脉侧支以及室间隔缺损和主动脉骑跨程度的价值。结果 在显示肺固有动脉方面,MDCT、TTE和心导管.与外科结果的一致性分别为99.1%,61.2%和93.6%。MDCT和心导管间一致性的差异无统计学意义(χ~2=3.29,P=0.07)。MDCT和TTE间一致性的差异有统计学意义(χ~2=50.01,P<0.0001)。MDCT能清楚显示外科探查到的275支粗大体肺侧支,一致性为100%。心导管与外科显示粗大体肺侧支的一致性为93.9%,MDCT和心导管造影一致性的差异有统计学意义(χ~2=14.84,P=0.0001)。MDCT和心导管与TTE显示主动脉骑跨的一致性分别为92.2%和90.4%。MDCT和心导管与TTE显示室间隔的一致性分别为95.7%和87.2%。结论 MDCT可以准确地显示肺动脉闭锁的肺固有动脉和心内畸形,是一种无创可靠的评价肺动脉闭锁的影像学检查方法。更多还原

【Abstract】 Objective To compare the diagnostic accuracy of MDCT,transthoracic echocardiography(TTE) and cardiac catheterization for pulmonary atresia accompanied with ventricular septal defect(PA-VSD).Methods The clinical and imaging data of 116patients with PA-VSD were reviewed.The performance of MDCT,TTE and catheterization for assessment of native pulmonary vasculture and intracardiac defects were evaluated.Results For showing pulmonary artery characterization,the agreed rates of MDCT,catheterization and TTE with surgery were 99.1%,93.6% and 61.2%,respectively.No significant difference in diagnostic agreement was showed between MDCT and catheterization(χ~2=3.29,P=0.07),and there was significant difference in diagnostic agreement between MDCT and TTE(χ~2=50.01,P<0.0001).MDCT correctly displayed 275 major aortopulmonary collateral arteries(MAPCAs) in all patients and the diagnostic agreements between MDCT and surgery were 100%.The diagnostic agreement between catheterization and surgery for delineation of MAPCAs was 93.9%.There was significant difference in diagnostic agreement between MDCT and TTE(χ~2=14.84,P=0.0001).The agreed rates between MDCT and TTE,catheterization and TTE for delineation of overriding aorta were 92.2% and 90.4%,respectively.The agreed rates between MDCT and TTE,catheterization and TTE for classification of ventricular septal defect were 95.7% and 87.2% respectively.Conclusion MDCT can correctly delineate the native pulmonary vasculture and intracardiac defects and is a reliable method for non-invasive assessment of global cardiovascular abnormalities in patients with PA-VSD.更多还原