256层多排探测器螺旋CT在儿童复杂先心病中的临床应用研究

The clinical value of the 256-slice multi-detector computed tomography in the diagnosis of complex congenital heart disease in children

目的:探讨256层多排探测器螺旋CT(256层CT)在儿童复杂先天性心脏病(CCDH)中的临床应用研究。方法:回顾性分析2009年8月—2011年5月在我院行256层CT心脏血管成像(CTA)和经胸部超声心动图(TTE)检查的69例14岁以下CCDH患儿的临床资料,所有患儿均经手术证实。CTA、TTE结果与手术结果对照,比较256层CT与TTE的诊断优势。结果:256层CT与TTE诊断心脏部分畸形的检出率分别为91.3%和98.8%,差异无显著统计学意义(P=0.07);256层CT与TTE诊断心脏大血管连接部畸形的检出率分别为95.7%和97.8%,差异无显著统计学意义(P=1.0);256层CT与TTE诊断心外大血管畸形的检出率分别为97.3%和84.0%,差异有显著统计学意义(P=0.012)。结论:256层CT在CCDH的诊断中检出率很高,尤其是在心外大血管畸形的诊断中,其检出率优于TTE。

Objective: To explore the clinical value of the 256-slice multi-detector computed tomography in the diagnosis of complex congenital heart disease in children.Methods: Datas of 69 patients under 14 years old with complex congenital heart disease,who underwent both computed tomography angiography(CTA) and transthoracic echocardiography(TTE) as preoperative examinations in our hospital from August 2009 to May 2011 were collected.All the patients were proved by operation.Results: As to cardiac abnormalities,the diagnostic accuracy rates of CT and TTE were 91.3% and 98.8% respectively,but the difference was not statistically significant(P=0.07).As to malformations of atrial ventricular great vessals connection,the diagnostic accuracy rates of CT and TTE were 95.7% and 97.8% respectively,but the difference was not statistically significant(P=1.0).As to large extracardiovascular malformation,the diagnostic accuracy rates of CT and TTE were 97.3% and 84% respectively,and the difference was statistically significant(P=0.012).Conclusion: The diagnostic accuracy rate of the 256-slice CT in the diagnosis of complex congenital heart disease is high,especilally in the diagnosis of large extracardiovascular malformation,with an accuracy rate of 97.3%,better than TTE.