多排螺旋CT评价房室间隔缺损

Multi-detector-row CT in evaluation of atrioventricular septal defect

目的探讨多排螺旋CT(MDCT)成像技术评价房室间隔缺损(AVSD)的临床应用价值。方法回顾性分析我院经外科手术或心血管造影确诊的28例AVSD患者的临床及相关影像资料,并将MDCT和超声诊断结果与手术和心血管造影结果进行对比。结果28例AVSD患者中,部分型5例、过渡型1例,中间型1例,完全型21例(其中A亚型13例、B亚型1例、C亚型7例)。MDCT检査误诊3例(包括2例部分型和1例中间型患者);超声检査误诊8例(包括1例中间型、1例部分型和6例A亚型),其余检査结果与手术或造影结果保持一致。MDCT与超声检査在AVSD患者4种分型的诊断正确率差异无统计学意义(P>0.05),而在完全型患者亚型的诊断中,差异有统计学意义(P<0.05)。结论 MDCT是诊断AVSD的准确有效的检查方法,尤其是当合并其他复杂心内外结构畸形时,与超声结合可提高诊断的全面性。

Objective To explore the clinical value of multi-detector-row CT（MDCT） in evaluating atrioventricular septal defect（AVSD）.Methods A total of 28 patients with AVSD verified by surgery or cardioangiography were analyzed retrospectively.The diagnostic results of MDCT and echocardiography（Echo） were compared with those of surgery or cardioangiography.Statistical analysis was used to compare the accuracy of MDCT and Echo techniques.Results Among the 28 patients with AVSD,5 of them were partial AVSD,1 was transitional AVSD,1 was intermediate AVSD and 21 were complete AVSD（including 13 of type-A,1 of type-B and 7 of type-C）.MDCT misdiagnosed 2 partial AVSD cases and 1 intermediate AVSD,while Echo made 8 mistakes,including 6 cases of type-A,1 case of intermediate AVSD and 1 case of partial AVSD.There was no statistical significance between the two techniques in distinguishing the four types of AVSD（P〉0.05）,but there was statistical significance between them in distinguishing the sub-type of complete AVSD（P〈0.05）.Conclusion MDCT combining Echo can obviously enhance the comprehensiveness of diagnosis for patients with AVSD,especially combining with other complex heart malformation.