64排螺旋CT诊断主动脉缩窄伴心脏畸形

Sixty-four-slice spiral CT diagnosis of coarctation of the aorta with heart malformations

目的探讨64排螺旋CT在主动脉缩窄伴心脏畸形中的临床诊断价值。方法对15例主动脉缩窄患者进行64层螺旋CT扫描,采用容积再现(VR)、最大密度投影(MIP)、多平面重组(MRP)等三维重建。结果 64排螺旋CT清晰显示15例主动脉缩窄,与手术结果一致;所有患者均为复杂畸形,其中合并动脉导管未闭6例、室间隔缺损6例(其中3例同时合并肺动脉高压)、主动脉瓣狭窄6例、继发心壁肥厚6例。VR明确显示主动脉缩窄的部位、长度和狭窄程度。64排螺旋CT在侧支循环及肺动脉显示方面明显优于心脏超声检查。结论 64排螺旋CT可清晰显示主动脉缩窄的类型、范围、程度及合并的心脏畸形,可作为诊断主动脉缩窄首选。

Objective To assess the diagnostic value of the 64-slice CT for coarctation of the aorta（CoA）with heart malformations.Methods Fifteen patients with CoA underwent 64-slice spiral CT,and then volume rendering（VR）,maximum intensity projection（MIP）and multiplanar reconstruction（MRP）were performed.Results Sixty-four-slice spiral CT clearly displayed all CoA consistent with surgery.All patients had complex malformation,including the merger of patent ductus arteriosus（n=6）,ventricular septal defect（n=6,of which 3 associated with pulmonary hypertension）,aortic stenosis（n=6）and left ventricular hypertrophy（n=6）.VR clearly showed the site,length and degree of stenosis in CoA.Sixty-four-slice spiral CT was superior to echocardiography in displaying of collateral circulation and the pulmonary artery.Conclusion Sixty-four-slice spiral CT can clearly show the type,scope,level and combined cardiac malformation in coarctation of the aorta,therefore should used as the preferred diagnostic method.