【摘要】 目的:比较右心声学造影与多排螺旋CT(Multi spiral computed tomography,MSCT)在复杂先天性心脏病(Complex congenital heart disease,CCHD)早期诊断中的应用价值。方法 :回顾性分析2017年6月—2019年6月在本院检查跟踪上一级医院行手术治疗的120例先天性心脏病患者,所有纳入患者术前均行右心声学造影和MSCT检测。记录两种方法对室间隔缺损、房间隔缺损、动脉导管未闭等病变的检出情况,以手术病理结果为金标准,采用Kappa一致性检验各方法诊断的准确率、灵敏度、特异性、阳性预测、阴性预测和Kappa值。结果:120例先天性心脏病患者经手术病理证实,CCHD患者44例,共存在心脏及大血管部分畸形137处。Kappa一致性分析显示,右心声学造影和MSCT诊断CCHD的准确率、灵敏度、特异性、阳性预测、阴性预测、Kappa值依次为92.50%、88.64%、94.74%、90.70%、93.51%、0.838和91.67%、84.09%、96.05%、92.50%、91.25%、0.817;右心声学造影对CCHD病变的检出率为94.16%,明显高于MSCT诊断的86.16%(P<0.05)。结论:右心声学造影和MSCT对于CCHD的诊断均有较好的一致性,而右心声学造影对于CCHD患者病变的检出率明显高于MSCT检查。更多还原

【Abstract】 Objective: To compare application value of right ventricle opacification(RVO) and multi-slice spiral computed tomography(MSCT) in early diagnosis of complex congenital heart disease(CCHD). Methods: A retrospective analysis was performed on 120 patients with congenital heart disease who were examined and followed up to receive surgical treatment in the superior hospital from June 2017 to June 2019. Before surgery, all patients underwent RVO and MSCT. The detective conditions of ventricular septal defect(VSD), atrial septal defect(ASD) and patent ductus arteriosus(PDA) by the two methods were recorded. Taking surgical pathological results as golden standard, Kappa consistency test was applied to determine accuracy,sensitivity, specificity, positive predictive value, negative predictive value and Kappa value. Results: Of the 120 congenital heart disease patients confirmed by surgery and pathology, there were 44 cases with CCHD. There were 137 sites with heart and large vessels malformations. Kappa consistency analysis showed that accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa value of RVO and MSCT for diagnosis of CCHD were 92.50%, 88.64%, 94.74%,90.70%, 93.51%, 0.838 and 91.67%, 84.09%, 96.05%, 92.50%, 91.25%, 0.817, respectively. The detective rate of RVO for CCHD lesions was significantly higher than that of MSCT(94.16% vs. 86.16%)(P<0.05). Conclusion: There is good consistency of both RVO and MSCT in diagnosis of CCHD. The detective rates of RVO are significantly higher than those of MSCT for lesions in CCHD patients.更多还原