16层CT在先天性胸部大血管异常诊断中的应用价值

The value of 16-slice CT in diagnosis of congenital abnormal thoracic great vessels

目的探讨16层CT血管成像对先天性胸部大血管异常的CT表现及其诊断应用价值。方法回顾性分析32例经16层CT对比增强检查的先天性胸部大血管异常患者结果,原始图像在工作站经多平面(MPR)、最大密度投影(MIP)、容积重建(VR)及血管分析技术等方法重建。32例作超声心动图(US)对照,32例均经手术或心血管造影检查证实。结果16层CT血管成像三维重建能清晰直观显示先天性胸部大血管异常的直接征象,其诊断敏感度、特异度、准确度分别为98.08%、98.08%、94.23%。在52处先天性胸部大血管异常中,16层CT误诊或漏诊3处,US误诊或漏诊14处。16层CT和US诊断准确率分别为94.23%、73.08%,16层CT诊断准确率明显高于US(P〈0.05)。结论16层CT对先天性胸部大血管异常的诊断优于US,与US相结合可大大提高对先天性胸部大血管异常的诊断准确率;16层CT可减少或部分取代有创的心血管造影检查。

Objective To discuss the manifestation and value of 16-slice CT angiography in diagnosis of congenital abnormal thoracic great vessels. Methods To analyse the results of 16-slice CT contrast enhancement of 32 cases of congenital abnormal thoracic great vessels retrospectively. All patients have been comfirmed by surgery and angiocardiography. The original images in the workstation were reconstructed by multiplanar （MPR）, maximum intensity projection （MIP）, volume reconstruction （VR） technology and vascular analysis methods. Compared the CT finding with echocardiography. Results The 16-slice CT angiography 3D reconstruction clearly and intuitively displayed the direct signs of congenital abnormal thoracic great vessels. Its diagnostic sensitivity, specificity, and accuracy were 98.08%, 98.08%, 94.23% respectively. In 52 congenital abnormal thoracic great vessels, the 16-slice CT misdiagnosed or missed 3, the US misdiagnosed or missed 14. 16-slice CT and US diagnostic accuracy rates were 94.23%, 73.08% respectively. The diagnostic accuracy of 16-CT was significantly higher than that US （P 〈0.05）. Conclusion The 16-slice CT in the diagnosis of congenital abnormal of thoracic great vessels is superior to US, combined with the US can greatly improve the diagnostic accuracy. The 16-slice CT can reduce or replace some of the invasive cardiovascular exam.