64层螺旋CT在新生儿及婴儿先天性心脏病诊断中的应用

Clinical value of 64-slice spiral CT in neonates and infants with congenital heart disease

目的:探讨64层螺旋CT对新生儿及婴儿先天性心脏病(CHD)的诊断价值。方法:对55例诊断CHD的新生儿及婴儿进行64层螺旋CT对比增强心脏检查,并用多平面重建、最大密度投影及容积成像进行图像重建。所有病例均做超声心动图(ECG)对照,并经手术证实。结果:64层螺旋CT、ECG对心血管畸形的诊断准确率分别为96.98%、71.86%,前者诊断准确率明显高于后者(χ2=23.88,P<0.005)。心内畸形68处中,64层螺旋CT、ECG的诊断准确率分别为92.65%、97.06%,两者无统计学差异(χ2=0.68,P>0.05)。心外畸形131处中,64层螺旋CT、ECG的诊断准确率分别为99.24%、58.78%,前者诊断准确率明显高于后者(χ2=32.32,P<0.005)。结论:64层螺旋CT是诊断CHD可靠的方法,弥补了ECG对心外畸形诊断的不足,尤其能评价主动脉、肺动脉以及冠状动脉,对术前手术方案的制定具有重要价值。

Objective To explore the clinical application of 64slice spiral CT in diagnosing congenital heart disease（CHD） of neonates and infants.Methods 55 neonates and infants with diagnosed CHD underwent cardiac CT angiography with 64-slice CT.Multi plannar reformation,maximum intensity projection and volume render were used to reconstruct image.Echocardiography（ECG） and operation were performed for all patients.Results The accuracy of 64-slice CT and ECG in detecting deformities of CHD were 96.98%,71.86% respectively.64-slice CT was superior to ECG in detecting deformities of CHD（χ^2=23.88,P〈0.005）.In 68 intra cardiac deformities,the accuracy of 64-slice CT and ECG were 92.65%,97.06% respectively.64-slice CT was as accurate as ECG in revealing intra cardiac deformities（χ^2=0.68,P〉0.05）.In 131 extra cardiac anomalies,the accuracy of 64-slice CT and ECG were 99.24%,58.78% respectively.64-slice CT was superior to ECG in identifying extra cardiac deformities（χ^2=32.32,P〈0.005）.Conclusion 64slice CT is credible technique for diagnosing CHD.It fetches up the shortage of ECG to diagnosis extra cardiac deformities.With its evaluation of aortic artery,pulmonary artery and coronary anomalies,64-slice CT is extremely valuable for planning the operative procedure on the patients with CHD.