多层螺旋CT诊断复杂型先天性心脏病

Multi-slice spiral CT diagnosis of complex congenital heart diseases

目的探讨16排螺旋CT(MSCT)在复杂型先天性心脏病(CCHD)中的扫描方法和重建技术。方法对184例CCHD患者,在未使用心电门控的情况下完成16排MSCT扫描,以多平面重建(MPR)、最大密度投影(MIP)、曲面重建(CPR)及容积再现(VR)等方法进行图像重建,将CT诊断结果与手术或心血管造影相对照。结果184例中,MSCT共检出616处畸形,并被手术或心血管造影证实,MSCT对心外畸形诊断准确率为100%,MSCT对房间隔缺损诊断准确率为54.65%(47/86),室间隔缺损诊断准确率为78.62%(114/145),而对于瓣膜性病变不能明确显示。结论MSCT能准确显示复杂型先天性心脏病的心外畸形。

Objective To investigate scanning and reconstruction techniques of multi-slice spiral CT（MSCT） in patients with complex congenital heart diseases（CCHD）.Methods One hundred eighty-four patients suffering from CCHD underwent 16-detector MSCT scanning without ECG-gating.Multi-planar reconstruction（MPR）,maximum intensity projection（MIP）,curved-planar reconstruction（CPR） and volume rendering（VR） were used to reconstruct images.CT findings were compared with those of surgical operation or angiocardiography.Results A total of 616 cardiac deformities were found with MSCT and proved by angiocardiograms or surgical operation.The diagnostic accuracy of extracardiac malformation with MSCT was 100%,of atrial septal defect was 54.65%,and of ventricular septal defect was 78.62%.MSCT failed to display heart valve disease well.Conclusion MSCT can accurately detect extracardiac malformations of CCHD.