新生儿及婴儿先天性心脏病多层螺旋CT心血管成像

Multi-slice computed tomographic cardioangiography in neonates and infants with congenital heart disease

目的 探讨新生儿及婴儿多层螺旋CT(MSCT)心血管成像技术及其对先天性心脏病的诊断价值。方法 MSCT对比增强心脏检查 83例 ,所有病例均作心脏超声 (US)对照 ,并经手术或X线心血管造影证实。结果 MSCT对先心病畸形的诊断敏感性 96.99%、特异性 99.5 7%、准确率 95 .71%。其中 ,心脏部分畸形 80处 ,MSCT与US诊断准确率差异无显著性意义 (χ2 =0 .879,P =0 .3 5 2 ) ;心外部分畸形 15 3处 ,MSCT诊断准确率明显高于US(χ2 =3 6.6,P =0 .0 0 0 )。MSCT与US联合诊断准确率 99.14 %。结论 MSCT对新生儿及婴儿先心病畸形的检出优于US 。

Objective To determine the optimal scan parameters, reconstruction methods and to demonstrate the possibilities and limitations of multi-slice computed tomographic cardioangiography in diagnosing congenital heart diseases of neonate and infant. Methods Eighty-three patients with congenital heart diseases were examined with contrast-enhanced multi-slice CT (MSCT). MSCT findings were compared with that of echocardiography (US). Surgical or cine angiocardiographic confirmation, which was used as the reference standard, was available in all patients. Results The sensitivity,specificity and accuracy of MSCT in detecting cardiac deformities were 96.99%,99.57%,95.71% respectively. In 80 intracardiac deformities, MSCT was as accurate as US in revealing intracardiac deformities (χ 2=0.879, P =0.352). In 153 extracardiac anomalies, MSCT was superior to US in the identifying extracardiac deformties (χ 2=36.6, P =0.000). Combination of MSCT and US could increase the definite diagnostic rate to 99.14%. Conclusion MSCT is superior to US in detecting neonates and infants congenital heart diseases. The combination of MSCT with US can improve definite diagnostic rate in neonates and infants congenital heart diseases.