高清CT容积螺旋穿梭技术在先天性心脏病中的初步研究

Volume helical shuttle of high-definition CT in congenital heart disease：preliminary study

目的 研究高清CT（HDCT）容积螺旋穿梭技术（VHS）在诊断先天性心脏病（CHD）方面的应用价值.方法 搜集行HDCT VHS扫描及超声心动图（ECHO）检查的CHD患者43例,分析经手术证实的24例（儿童21例,成人3例）HDCT结果,与ECHO结果进行对比,评价HDCT对CHD病变、血流动力学、冠状动脉及合并心外病变的显示能力.有效剂量（mSv）=剂量长度乘积（DLP） ×K.结果 手术证实心内畸形36处,HDCT符合率100.0％（36处）与ECHO一致.心脏大血管连接部及心外血管畸形44处,HDCT符合率（95；4％,42/44）明显优于ECHO （59.1％,26/44）.ECHO提示间隔缺损右向左及左向右分流分别为5和6例,HDCT均符合；双向分流14例,HDCT除1例观察不清外,其余13例仅显示右向左分流.HDCT冠状动脉开口及近段走行均完全显示.有效剂量：儿童（3.38±1.86） mSy,成人（10.27±2.59）mSv.结论 HDCT VHS诊断CHD中有较大优势,能够准确、无创地反映心脏、心外结构及血流动力学信息,为临床诊断提供帮助.

Objective To assess the clinical value of volume helical shuttle （VHS） of highdefinition CT （HDCT） in the diagnosis of congenital heart disease （CHD）.Methods Forty-three patients suffering from CHD were examined with VHS of HDCT and echocardiography （ECHO）.Twenty-four patients （21 children,3 adults） received surgery.Based on surgical data,the diagnostic accuracy of CHD by VHS of HDCT was compared with that by ECHO with respect to the intra-cardiac lesion,extra-cardiac lesion and hemodynamics.The visibility of the origin and proximal course of coronary arteries was also evaluated on VHS.CT effective doses were calculated,using mSv =DLP × K. Results Thirty-six intra-cardiac deformities were found by operation,and the diagnostic accuracy of both VSH and ECHO were 100.0% （36/36）.VHS successfully detected 42 of 44 （95.4%） cardiac-vascular connection and large vascular deformities,whereas ECHO only detected 26 （59.1% ）.The right-to-left shunt and left-to-right shunt of septal defects revealed by VHS were 5 and 6 patients respectively,which all coincided with the results of ECHO.Fourteen bi-directional shunt of septal defects were detected by ECHO,and 13 of them were diagnosed as right-to-left shunt by HDCT except an illegibility in 1 patient.The origin and proximal course of coronary arteries were all visible on VHS.Effective dose for children was （3.38 ± 1.86） mSv,and for adults was （ 10.27 ± 2.59） mSv.Conclusions VHS of HDCT scan is advantageous in the diagnosis of CHD.It can depict the intra- and extra- cardiac structures as well as coronary arteries and provide hemodynamic information.