双源CT诊断川崎病冠状动脉病变

Dual-source CT in diagnosis of Kawasaki disease with coronary arterial lesions

目的探讨双源CT(DSCT)诊断川崎病冠状动脉病变的临床应用价值。方法 对16例川崎病冠状动脉病变患者进行DSCT冠状动脉成像,将获得的数据进行容积再现(VR)、多平面重建(MPR)、最大密度投影(MIP)、曲面重建(CPR),观察冠状动脉病变的部位、数目、形态和大小,并和同期超声心动图(ECHO)进行比较分析。结果 16例川崎病患者共累及22支血管,表现为单纯性冠状动脉扩张4例、单纯性冠状动脉狭窄2例、冠状动脉瘤10例(共28个),其中2例冠状动脉瘤伴钙化、4例冠状动脉瘤伴冠状动脉扩张。ECHO未显示的病变为小冠状动脉瘤4个(右冠状动脉远段2个、左前降支远段及左回旋支中段各1个)、冠状动脉钙化2例、冠状动脉狭窄1例、冠状动脉轻度扩张1例。结论 DSCT能清晰全面显示冠状动脉病变及程度,是川崎病冠状动脉病变患儿诊断和随访的重要评估方法。

Objective To observe the value of dual-source CT（DSCT） in diagnosis of Kawasaki disease（KD） with coronary arterial lesions（CAL）.Methods Totally 16 patients with known KD with CAL were examined with DSCT.The source images were post processed using volume rendering（VR）,multiple planar reformation（MPR）,maximum intensity projection（MIP） and curved planar reformation（CPR）.The location,number,shape and size of CAL were recorded and compared with those of echocardiography（ECHO） simutaneously.Results DSCT showed CAL in 16 patients involving 22 coronary arteries,including 4 patients with simple dilated coronary arteries,2 with simple coronary arteries stenosis and 10 with 28 coronary arterial aneurysms.Two patients with aneurysm calcification and 4 patients with aneurysm dilation were found.ECHO failed to detect 4 small aneurysms,including 2 located in the distal segments of the right coronary artery,1 in distal segment of left anterior descending artery（LAD） and 1 in middle segment of left circumflex artery（LCX）.Two patients with calcification,1 with stenosis and 1 with dilatation of coronary artery were not found with ECHO also.Conclusion DSCT can be used to display the location and extent of CAL,having an important clinical significance in the diagnosis and prognosis of KD with CAL.