多层螺旋CT(MSCT)在主动脉缩窄诊断中的临床价值

Clinical Value of Multislice Spiral CT(MSCT) in the Diagnosis of Aortic Coarctation

目的通过与B超和手术所见,评价多层螺旋CT(MSCT)在诊断主动脉缩窄(CoA)中的临床价值。方法主动脉缩窄患者52例,单纯型18例,复杂型34例;26例在我院或外院行手术治疗,33例均行B超检查。结果本组MSCT共诊断CoA52例,单纯型13例,占25%,复杂性婴儿型35例,占67.3%,复杂不典型型4例,占7.7%,MSCT诊断局限性缩窄31例(59.6%),管性缩窄21例(40.4%)。46例CoA中最窄处内径与主肺动脉水平升主动脉内径比值R为0.29±0.13,轻度缩窄2(4.3%)例,中度缩窄23(50.0%)例,重度缩窄21(45.7%)例。26例经手术证实的CoA病例中MSCT均明确诊断,准确率为100%(26/26)。超声心动图检查18例明确诊断,2例诊断可疑,6例漏诊,准确率为69.2%(18/26)。结论在诊断主动脉缩窄上,MSCT明显优于心脏超声(transthoracic echocardiography,TTE),B超可以作为诊断主动脉缩窄筛查手段,MSCT可以作为手术的依据。

Objective To investigate the clinical usefulness of imaging techniques in the diagnosis of congenital coarctation of the aorta （CoA）. Methods 52 patients with CoA were studied, inchiding 18 cases of simple type and 34 cases of cornplex type, 26 cases of them underwent surgery, 33 cases were examined by two-dimensional echocardiography（2DE）and color Doppler llow imaging （CDFI）. Results MSCT in this group of patients diagnosed CoA52, Simply type in 13 cases （25%）, infantile complexity in 35 cases （67.3%）： 4 cases of complex atypical （7,7% 7, MSCT diagnosis of 31 cases of coarctation limitations （59.6%）, Tube constrictive 21 cases （40.4%）. In 46 CoA, Narrowest diameter of the ascending aorta and main pulmonary artery diameter ratio R level was 0.29 - 0.13, Mild coarctation 2 cases （4.3%）, Moderate coarctation 23 cases （50.0%）, Severe coarctation 21 cases （45.7%7. 26 cases confirmed by surgery CoA MSCT cases were diagnosed, the accuracy was 100% （26/26）. Echocardiography 18 cases diagnosed, two cases diagnosed suspicious, 6 cases of misdiagnosis, the accuracy was 69. 2% （18126）. Conclusion In diagnosing coarctation of aorta, CAG and MSCT are superior to TTE. MSCT and TTE are important Don invasive methods for detecting CoA. In the diagnosis of CoA, TTE is the first method of choice. If not wanting to get the information of circulation or interventional therapy MSCT can replace the technique of CAG.