64层螺旋CT在复杂先天性心脏病诊断中的应用

Evaluation of complex congenital heart diseases with 64-slice CT

目的评估64层螺旋CT(MSCT)在复杂先天性心脏病(CCHD)诊断中的应用价值。方法回顾性分析32例CCHD患者的MSCT检查资料;其中男18例,女14例,平均年龄14.1岁。使用Philips Brilliance 64 64层CT机。双期扫描。11例患者采用回顾性心电门控。所有32例行超声心动图检查(ECHO),11例行心血管造影(CAG),手术25例。结果以手术或CAG检查为诊断标准,64层MSCT在复杂先天性心脏病心外大血管畸形方面诊断符合率为97.9%(46/47),明显优于超声心动图(ECHO)(χ2=30.62,p<0.001);心内畸形诊断符合率88.4%(38/43),与ECHO差异无统计学意义(χ2=2.87,p>0.05);心脏-大血管连接异常诊断符合率100%,与ECHO差异有统计学意义(χ2=4.35,p<0.05)。结论64层MSCT可有效检出心内和心外大血管畸形,在CCHD诊断中是一种准确的无创性方法。

Objective To evaluate the advantage and limitation of multislice CT（MSCT） in complex congenital heart disease（CCHD）. Methods The MSCT data of 32 patients（18 male, 14 female; mean age 14.1 years） with CCHD were analyzed retrospectively. Dual-stage enhanced scanning underwent on Philips Brilliance 64 scanner, retrospective ECG gating technique was used in 11 patients. All of the patients were performed with echocardiograms（ECHO）, 11 with angiocardiograms （CAG）, and 25 surgical operations. Results The operation results or CAG was taken as diagnostic standard. The definite diagnosis of MSCT in great arteries anomalies was 97.9%（46/47）,significantly superior to ECHO （χ^2=30.62, p〈0.001 ） ; in intraeardiae anomalies was 88.4% （38/43）, showing no statistical difference with ECHO （χ^2=2.87, p〉0.05） ; in cardiac-artery anomalies was 100%,there was statistical significance between MSCT and ECHO（χ^2=4.35,p〈0.05）. Conclusion 64-multislice spiral CT may be used to efficiently detect the intra and extraeardiac anomalies as a non-invasive technique in diagnosis of CCHD.