【摘要】 目的分析双源CT(dual-source computed tomography,DSCT)对儿童先天性心脏病(先心病)肺动脉瓣狭窄的评价能力。方法选取经手术证实存在肺动脉瓣狭窄的先心病患儿98例。采用双斜位多平面重组进行图像后处理,将肺动脉瓣成像效果评为1～4分,比较4个年龄段及3个心率水平下肺动脉瓣评分差异,并将评分与年龄、心率进行相关性分析。以手术为对照,评价DSCT对肺动脉瓣的评价效果。结果 72例(73.5%)图像质量评分≥3分,可用于诊断。年龄<1岁组与≥1～3岁组、≥3～7岁组与≥7～14岁组得分差异无统计学意义(P>0.05),其余各组间差异均有统计学意义(大龄组高于小龄组)。心率<90次/min(bpm)组,90～110 bpm组,>110bpm组评分依次降低而不完全相同(F=19.05,P<0.01)。心率与评分呈负相关(r=-0.391,P<0.001),年龄与评分的相关性无统计学意义(r=0.185,P=0.070)。DSCT对肺动脉瓣瓣叶数目、形态、关闭线位置及瓣膜开放情况等的评价均与手术相符。结论 DSCT能够较好评价先心病患儿的肺动脉瓣,对治疗方案的制定和手术方式的选择具有重要的指导意义。患儿的心率是影响成像效果的重要因素。更多还原

【Abstract】 Objective To analyze the capability of dual source computed tomography(DSCT) in evaluation of pulmonary valve stenosis(PVS) in children with congenital heart disease.Methods Ninety eight children(46 males,52 females) with congenital PVS confirmed by surgery were collected in the study.Double-oblique multiplanar reformation was applied.Image quality of pulmonary valves were scored as 1-4 points.The differences of image quality score were analyzed among 4 groups of various heart rates and 3 groups of various ages.Partial correlation analysis was used to analyze the effects of age and heart rate on image scores.Number and shape of leaves that demonstrated by DSCT were compared with operation findings.Results 73.4%(72/98) of pulmonary valves images were good enough for diagnosis.Image quality scores had no significant difference between 0-1 years old group and other age groups(P>0.05),whereas image quality scores of the rest groups had significant difference.Image quality scores were decreased with the heart rate increased(F=19.05,P<0.01).Heart rate had negative correlation with image quality score(r =-0.391,P <0.001),but the age had no significant correlation with image quality score(r =-0.391,P <0.001).The leaves number,shape,commissure and their opening status that demonstrated by DSCT were consistent well with operation.Conclusion DSCT could show pulmonary valves of children with PVS clearly.DSCT is useful for determining treatment perscription and surgical approach.Heart rate is a main influential factor to imaging quality.更多还原