二叶式主动脉瓣的多层螺旋CT诊断

Diagnosis of Bicuspid Aortic Valve with Multi-Slice CT

目的采用心电门控CTA检查研究二叶式主动脉瓣畸形(BAV)患者主动脉瓣及胸主动脉的形态学特征,并对比分析其与常见主动脉瓣疾病鉴别要点。方法回顾性分析14例经心电门控CTA检查的BAV患者,分析其影像学表现,并与风湿性心脏病主动脉瓣病变患者及单纯主动脉瓣钙化患者的瓣膜情况、主动脉直径及左心房情况进行对比,进行统计学分析。结果心电门控CTA检查配合合适的后处理手段能良好显示BAV二叶主动脉瓣及双冠窦等解剖特征,并能对主动脉瓣增厚及钙化进行显示;BAV患者的瓣膜增厚及钙化情况与风湿性心脏病患者类似,升主动脉及降主动脉管径及两者之比大于风湿性心脏病和单纯主动脉瓣钙化患者。结论心电门控CTA检查对BAV的诊断有重要价值,在胸部CT检查中存在主动脉瓣钙化、升主动脉扩张及升/降主动脉比值增大的患者要警惕BAV存在,通过多种后处理手段能提高BAV的检出率。

Objective Using ECG-gated CTA,studies the morphological features of BAV patients in thoracic aorta and aortic valve,and compared with the common aortic valve disease. Methods 14 cases of BAV patients underwent ECGgated CTA were retrospectively analysised,including imaging findings,compare and patients with rheumatic heart disease and aortic calcification in patients with pure aortic valvular disease,the aorta and the left atrium diameter situation In contrast,for statistical analysis. Results With appropriate post-processing means,ECG-gated CTA can be a good examination for showing BAV bicuspid aortic valve and crown sinus and other anatomical features,and is able to display aortic valve thickening and calcification; BAV patients with valvular thickening and calcification situation is similar in patients with rheumatic heart disease,the ascending aorta and the descending aorta and both diameter ratio greater than rheumatic heart disease in patients with aortic valve calcification and simple. Conclusion ECG-gated CTA examination of the bicuspid aortic valve malformation diagnosis has important value,the presence of aortic valve calcification in the chest CT examination,aortic dilatation and ascending / descending aorta ratio is increased in patients with aortic valve to be vigilant two leaf deformity exists,through a variety of post-processing means to improve bicuspid aortic valve malformation detection rate.