复杂型先天性心脏病多层螺旋CT血管成像与超声心动图对比研究

Comparative Study of 16-slice CT and Ultraocardiography on the Diagnosis of Complex Congenital Heart Disease

目的对比研究16层螺旋CT血管成像和超声心动图在复杂型先天性心脏病(先心病)中的临床应用价值。资料与方法38例行16层螺旋CT血管成像的复杂型先心病患者中,21例经手术或多种影像学方法证实,并均行彩色超声心动图检查,以手术结果或多种影像学方法为标准,将16层螺旋CT和超声心动图进行对比。结果21例患者中,16层螺旋CT正确诊断了所有复杂型先心病的类型,超声心动图正确诊断17例。21例患者中发现心内畸形32个,心外畸形48个。16层螺旋CT、超声心动图对心内畸形诊断的准确率分别为65.63%、100%,差异有显著性意义;对心外畸形诊断的准确率分别为97.92%、54.17%,差异有显著性意义;总的诊断准确率分别为85%、72.5%,差异无显著性意义。结论16层螺旋CT在心外血管结构的显示上较超声心动图有优势,而超声心动图对心内结构的评价更准确。在临床中将多层螺旋CT血管成像和超声心动图结合,将极大提高对复杂型先心病的诊断准确性。

Objective To compare the clinical application value of 16 slice CT angiography with ultraocardiography （UCG） in diagnosis of complex congenital heart disease. Materials and Methods 21 patients confirmed by surgical or other radiological methods performed 16 slice CT angiography and UCG. Compared the results of CT and UCG. Results Among 21 cases, CT correctly diagnosed all the types of complex congenital heart disease, while UCG diagnosed in 17 types. The total number of anomalies was 80, including 32 intracardiac anomalies and 48 extracardiac anomalies. The diagnostic accuracy of CT and UCG for the intracardiac anomalies was 65.63%, 100% respectively, and for the extracardiac anomalies was 97.92% ,54.17% respectively. There were statistically significant differences between CT and UCG. for accuracy diagnosis of intracardiac anomalies and extracardiac anomalies. The total accuracy of CT and UCG was 85% ,72.5% respectively,and there was not statistically significant difference between CT and UCG for total accuracy. Conclusion 16 slice CT angiography is superior to UCG in detection of extracardiac anomalies ,while UCG is superior to CT in detection of intracardiac anomalies. The diagnostic accuracy of complex congenital heart disease will be improved if CT angiography was combined with UCG.