合并大血管畸形的复杂型先天性心脏病CT与超声的对比研究

Comparative Study on Inspection of Complex Congenital Heart Disease in Patients with Major Vascular Anomalies with Multi-slice Spiral CT and Echocardiography

目的比较64层螺旋CT和超声心动检查对复杂型先天性心脏病(CCHD)患者大血管异常的诊断价值。方法选择2010年5月至2013年7月河北省人民医院及河北医科大学第二医院心脏外科收治的CCHD患者39例,均进行超声心动检查和心脏大血管增强CT检查。完成全部检查后所有患者均经手术证实。比较超声心动检查和心脏大血管增强CT检查对CCHD的诊断准确率。结果 39例CCHD患者中法洛四联症18例,内脏心房异位综合征6例,血管环3例,先天性主动脉缩窄12例。合并心外大血管异常的39例CCHD患者在CT上全部都得到了明确的诊断,而超声心动检查仅对其中的27例做出了正确的提示,其诊断准确率为69.2%,差异有统计学意义(χ2=4.232,P<0.05)。结论 64层螺旋CT扫描技术能够提高CCHD患者大血管异常的正确诊断率,术前正确诊断对CCHD的手术治疗至关重要。

Objective To compare the diagnostic value of multi-slice spiral CT and echocardiography to display vascular anomalies in complex congenital heart disease（ CCHD） patients. Methods The study objects were 39 CCHD patients chosen from the Cardiac Surgery Department of Hebei General Hospital and The Second Hospital of Hebei Medical University during May 2010 and Jul.2013. All patients received echocardiography and cardiac vascular multi-slice spiral CT examination.All patients were confirmed by operation after examination. Comparison of the diagnostic accuracy of echocardiography examination and cardiac vascular enhancement CT examination for CCHD was done. Results Among the 39 patients with CCHD,there were 18 cases of tetralogy of Fallot,6 cases of visceroatrial heterotaxy syndrome,3 cases of vascular rings,and 12 cases of congenital coarctation of aorta. All CCHD patients with cardiac vascular abnormality got definite diagnosis by CT,while only 27 cases got correct indication by echocardiography,the diagnostic accuracy rate was 69. 2%（ χ2= 4. 232,P〈 0. 05）. Conclusion Multi-slice spiral CT scanning technology can improve the correct diagnosis rate in the CCHD patients with vascular anomalies. Preoperative diagnosis is essential to the operation treatment of CCHD.