室间隔缺损型肺动脉闭锁的CT诊断价值

CT Diagnosis of Ventricular Septal Defect Pulmonary Atresia

目的探讨双源CT低剂量扫描及其后处理技术对室间隔缺损型肺动脉闭锁的诊断价值。方法回顾性分析该院2010年1月—2017年6月诊治的21例室间隔缺损型肺动脉闭锁患者双源CT及经胸心脏二维超声(TTE)资料,记录肺动脉闭锁部位、体-肺侧支血管、合并心血管畸形、支气管异常、肺炎及其他临床合并症情况。结果 21例患者中,Ⅰ型1例;Ⅱ型7例;Ⅲ型11例;Ⅳ型1例;Ⅴ型1例。肺侧支循环主要来源于降主动脉,其次为动脉导管、支气管动脉等。合并其他主要心血管畸形83处,主要包括:动脉导管未闭、房间隔缺损、大动脉转位等,其中CT漏诊2处,超声14处,合并支气管异常5例,肺炎12例,均由CT诊断。结论双源CT低剂量扫描联合多种重建技术能直观、精准显示室间隔缺损型肺动脉闭锁部位、体-肺侧支血管及其伴发的心血管畸形及呼吸系统异常,为外科手术方案的制定提供重要依据。

Objective This paper tries to investigate the diagnostic value of dual-source CT low-dose scanning and postprocessing techniques for ventricular septal defect pulmonary atresia. Methods A retrospective analysis of 21 patients with ventricular septal defect pulmonary atresia diagnosed and treated in our hospital from January 2010 to June 2017 was performed using dual-source CT and transthoracic echocardiography（TTE）. Pulmonary atresia was recorded and the body-pulmonary collateral was recorded. Vascular, combined cardiovascular malformations, bronchial abnormalities, pneumonia, and other clinical comorbidities. Results Of the 21 patients, 1 was type I; 7 were type II; 11 were type III; 1 was type IV; and 1 type V. The pulmonary collateral circulation mainly came from the descending aorta, followed by the arterial catheter,bronchial artery and so on. There were 83 other major cardiovascular malformations, including： patent ductus arteriosus, atrial septal defect, transposition of great arteries, etc. There were 2 missed CT scans, 14 ultrasounds, 5 bronchial abnormalities, and 12 pneumonias. All were diagnosed by CT. Conclusion The dual-source CT low-dose scan combined with multiple reconstruction techniques can visually and accurately display ventricular septal defect pulmonary atresia sites, body-pulmonary branch vessels and their associated cardiovascular malformations and respiratory abnormalities, providing surgical planning Important reference.