多层螺旋计算机断层摄影术在主动脉窦瘤破裂手术前诊断中的应用价值

Pre-operative Diagnostic Value of Multislce Spiral Computed Tomography in Patients With Rupture Sinus of Valsalva Aneurysm

目的:初步探讨多层螺旋计算机断层摄影术(MSCT)在主动脉窦瘤破裂(RSVA)术前诊断中的应用价值。方法:回顾性分析2011-08至2014-06 MSCT诊断并经手术证实的12例RSVA患者的MSCT影像特点,并与手术结果对比。结果:12例RSVA患者中右冠状窦瘤9例,无冠状窦瘤2例,左冠状窦瘤1例;其中窦瘤破入右心室流出道7例,破入右心室3例,破入右心房2例。MSCT诊断RSVA发生部位和破入心腔位置方面与手术结果一致。但MSCT分别漏诊室间隔缺损5例和室间隔膜部瘤1例。结论:MSCT在RSVA术前诊断中具有优良价值。但在临床工作中应仔细观察,避免漏诊RSVA合并的其他心血管畸形。

Objective： To preliminarily explore the pre-operative diagnostic value of rupture sinus of valsalva aneurysm （RSVA） by multislce spiral computed tomography （MSCT）. Methods： We retrospectively analyzed the characteristics of MSCT in 12 RSVA patients with surgically confirmed diagnosis from 2011-08 to 2014-06 in our hospital and compared the MSCT findings with the surgical results. Results： There were 9/12 patients with RSVA originated from right sinus, 2 originated from non-coronary sinus and 1 originated from left sinus. There were 7 patients with the rupture into right ventricular outflow tract, 3 with rupture into right ventricle and 2 with rupture into right atrium. MSCT findings of RSVA location and rupture into heart chamber position were consistent with surgical results, while MSCT missed 5 cases of ventricular septal defect and 1 case of aneurysm at membranous septum. Conclusion： MSCT has the excellent value for RSVA pre-operative diagnosis; while careful observation is important in clinical practice to avoid missing the RSVA combined cardiovascular malformation.