多层螺旋CT在右室双出口诊断中的应用价值

Application of MSCT in the Diagnosis of Congenital Heart Disease with Double Outlet Right Ventricle (DORV)

目的:探讨多层螺旋CT(MSCT)在右室双出口诊断中的应用价值。方法:75例经临床、X线片、心脏超声(UCG)拟诊为右室双出口的再行MSCT检查,采用心脏节段分析法分析内脏-心房位、心室袢、大动脉关系,另外,观察室间隔缺损部位、有无肺动脉狭窄、主动脉异常及其它并发畸形,并将CT结果与手术结果进行对照。结果:75例手术证实右室双出口中,MSCT定性诊断正确73例,误诊2例。75例均有室间隔缺损。肺动脉高压10例,肺动脉狭窄53例,心脏大血管连接部分及心外并发畸形共72处,小房间隔缺损或卵圆孔未闭漏诊4处。结论:MSCT对右室双出口的解剖诊断及分型具有重要价值。观察心脏大血管连接部分及心外大血管畸形有明显优势,能显示冠状动脉情况。

Objective：To investigate the diagnostic value of muhi slice spiral CT （MSCT） in douhle outlet right yen tricle （DORV）. Methods： 75 cases who were given paradiagnosis as dominant double outlet hy clinical findings,X ray films, and uhrasound were re inspected by MSCT. By using segmental analysis the relations among internal organs cardiac atrium, ventricular loop, and aorta were analyzed. In addition, sites of ventricular septal defect were observed to see if there were any pulmonary stenosis,aortic abnormalities and other deformities. The results of CT and surgery were compared. Results： In 75 eases of double outlet right ventricle confirmed by surgery, MSCT provided accurate qualitative diagnosis for 73 cases,with 2 cases of wrong diagnosis. There were vcntrieular septal defect in 75 cases,pulmonary hypertension in 10 cases,pulmonary stenosis in 53 cases, 72 deformities in the connection of the heart with the aorta and vessels around the heart. MSCT missed 4 cases of small atrial septal defect or patent foramen ovale. Conclusion： MSCT has important diagnostic value for double outlet right ventricle of the anatomical diagnosis and classification. MSCT holds an obvious advantage in the observation of malformations in connection of the heart with aorta or large blood vessels outside the heart. It can clearly display coronary artery origin and the situation of pathway.