64层螺旋CT血管造影在法洛四联症诊断中的应用

Application of 64-slice spiral CT angiography in the diagnosis of tetralogy of fallot

目的:探讨64层螺旋CT血管造影(64-SCTA)诊断法洛四联症(tetralogy of Fallot,TOF)的应用价值。方法:回顾性分析23例TOF患者的64-SCTA诊断结果,并与心脏超声(UCG)和手术进行对比。结果:23例TOF患者经64-SCTA和UCG都能发现和准确诊断TOF的4种主要畸形,室间隔缺损大小、主动脉骑跨程度、右室流出道狭窄、右室前壁厚度以及主肺动脉内径的测量结果与手术结果比较均差异无统计学意义(均P>0.05);64-SCTA检出体肺侧支动脉血管6例,UCG仅检出1例,二者比较,差异有统计学意义(P<0.01)。结论:64-SCTA能客观清晰地显示TOF的4种畸形,在心外大血管畸形诊断方面较UCG有明显的优势,是准确诊断TOF无创性检查的理想选择。

Objective：To evaluate the advantage and limitation of 64-slice spiral CT angiography（64-SCTA） in diagnosing tetralogy of fallot（TOF）.Method：64-SCTA findings of 23 patients with TOF were retrospectively analyzed comparatively with cardiac ultrasound and surgery.Result：Four major malformations of TOF could be accurately diagnosed by both 64-SCTA and cardiac ultrasound.There was no significant statistically difference（P0.05） compared with that of surgery in evaluating the ventricular septal defect size,degree of aortic cross-riding,stenosis of right ventricular outflow,as well as internal diameter of main pulmonary,left and right pulmonary artery.the right ventricular wall thickness were no significant statistically difference（P0.05） measured by 64-SCTA and cardiac ultrasound,but 64-SCTA had more advantages than cardiac ultrasound in diagnosing the extracardiac malformation（P0.01）,for the detection of lung body collateral arteries by 64-SCTA in 6cases,while only 1case by cardiac ultrasound.Conclusion：Four major malformations of TOF could be objectively and clearly diagnosed by 64-SCTA.In diagnosis of great extracardiac vessel malformations,64-SCTA is significantly superior to UCG.64-SCTA is a accurate and non-invasive technique in diagnosis of TOF.