双源CT血管成像在评价肺动脉闭锁合并室间隔缺损中的临床价值

Clinical Value of ECG-gated Dual-source Computed Tomography and Angiography in Assessing Pulmonary Atresia with Ventricular Septal Defect

探讨心电门控双源CT血管成像(DSCTA)在评价肺动脉闭锁合并室间隔缺损(PA-VSD)中的临床价值。回顾性分析20例行DSCTA检查的肺动脉闭锁合并室间隔缺损患者的CT资料。重点分析肺动脉闭锁合并室间隔缺损的分型、肺动脉发育情况、主肺侧支血管(MAPCAs),并观察其它合并的心内及心外畸形。20例PA-VSD中,A型6例,B型13例,C型1例。12例患者有未闭合动脉导管(PDA),其中6例由PDA供血,其余14例主要由MAPCAs供血。MAPCAs直径约(7.2±3.4)mm(范围,2.0～14.3mm)。DSCTA是一种简便、无创的心血管成像方法,可以准确评价PA-VSD的分型、肺动脉发育情况和MAPCAs,为术前提供详细的解剖学信息。

The purpose of this study is to explore the clinical value of ECG-gated dual-source CT angiography （DSC- TA） in evaluating pulmonary atresia with ventricular septaI defect （PA-VSD）. We carried out retrospective analysis on 20 patients who had DSCTA with PA-VSD. The emphasis of the work was on analyzing the types of PA-VSD, pulmonary artery development, major aorto-pulmonary artery collateral arteries （MAPCAs） and associated intra- and extra-cardiac malformations. In the 20 cases of PA-VSD, there were 6 cases of type A , 13 cases of type B, and 1 case of type C. 12 cases of the patients had patent ductus arteriosus （PDA）. The pulmonary blood flow was mainly supplied by PDA in 6 cases and by MAPCAs in the rest of 14 cases. The diameter of MAPCAs was （7.2士3.4）mm （range, 2.0-14. 3 mm）. The experiments proved that ECG-gated DSCTA was a convenient and noninvasive cardiovascular imaging method, and it could accurately evaluate the types of PA-VSD, pulmonary artery development, MAPCAs, and it could also provide detailed anatomic information before surgery.