平板数字旋转右室造影在法洛四联症中的临床应用

Clinical Application of the Rotational Plane Digital Right Ventriculography in Diagnosis of Tetralogy of Fallot

目的:与常规右室造影比较,探讨平板数字旋转右室造影在法洛四联症(TOF)中的临床应用价值。方法:对39例法洛四联症患者行平板数字旋转右室造影,详细记录从右前斜(RAO)35°到左前斜(LAO)70°各种主要畸形及解剖所见,包括右室流出道、肺动脉主干、左肺动脉起始部、右肺动脉起始部、室间隔缺损、主动脉骑跨度、冠状动脉开口及走行、动脉导管未闭(PDA)、侧支血管及其他畸形等;选取同一患者,在TOF常规造影体位RAO30°头位及LAO60°头位观察造影所见,并进行对照分析。结果:右室流出道、肺动脉主干、左肺动脉起始部、右肺动脉起始部、室间隔缺损、主动脉骑跨度、冠状动脉开口及走行、PDA、侧支血管及其他畸形等在旋转造影中除左肺动脉起始部良好显示率为97%,其余均为100%;而在RAO30°头位、LAO60°头位,良好显示率分别为87%、82%、77%、87%、82%、82%、72%、0%;旋转造影与常规造影在肺动脉主干、左肺动脉起始部、室间隔缺损、主动脉骑跨、冠状动脉开口及走向显示上的差异有统计学意义(P<0.05)。结论:旋转造影较常规造影能提供更丰富的影像学信息,可从任意角度观察心腔、血管的情况,为临床治疗提供更多有益的资料。

Objective： To compare the clinical value of the rotational right ventriculography and conventional right ventriculography in the diagnosis of tetralogy of fallot. Methods：The rotational right ventriculography was performed in 39 cases of tetralogy of fallot. Right ventricular outflow tract, pulmonary artery,left pulmonary artery, right pulmonary artery, ventricular septal defect,overriding of the aorta, coronary artery, patent ductus arteriosus and collateral arteries were oh- served and compared between the rotational right ventriculography （from RAO 35% to LAO 70% views） and conventional right ventriculography （RAO 30%and LAO 60% views）. Results： RAO 30%and LAO 60% views right ventriculography clearly demonstrated right ventricular outflow tract in 34/39, pulmonary artery in 32/39 ,left pulmonary artery in 30/39, right pul- monary artery in 34/39, ventricular septal defect in 32/39, overriding of the aorta in 32/39, coronary artery in 28/39, patent ductus arteriosus and collateral arteries in 0. The rotational right ventriculography clearly demonstrated right ventricular outflow tract, pulmonary artery, right pulmonary artery,ventricular septal defect,overriding of the aorta, coronary artery, patent ductus arteriosus and collateral arteries in all cases, except left pulmonary artery in 38/39. There was statistical difference between the rotational right ventriculography and conventional right ventriculography in demonstrating pulmona- ry artery, left pulmonary artery, ventricular septal defect, overriding of the aorta, coronary artery （ P 〈 0.05 ）. Conclusion： More valuable anatomic information can be obtained with the rotational right ventriculography than with the conventional right ventriculography in the diagnosis of tetralogy of fallot.