320排CT血管造影联合经胸壁超声检查诊断复杂型先天性心脏病的价值

Application of 320-row detector CT angiography combined with transthoracis echocardiography in diagnosis of complicated congenital heart diseases

目的:探讨320排CT血管造影(CTA)联合经胸壁超声(TTE)诊断复杂型先天性心脏病(CCHD)的价值。方法:收集43例经手术证实CCHD的CTA及TTE检查结果,按照心内畸形与心外畸形分组,分析单一CTA及CTA联合TTE检查后的漏、误诊情况。结果:与手术结果对照,单一CTA与联合应用TTE诊断心内畸形漏、误诊率分别为13.8%、2.3%,心外畸形漏、误诊率分别为8.2%、4.5%,对所有畸形漏、误诊率分别为10.7%、3.6%,两者在心外畸形的诊断上未见统计学差异,而在心内畸形及总体心脏畸形的判断上具有统计学差异,联合应用优于单一CTA检查。结论:CTA联合TTE检查较单一CTA检查可以降低CCHD诊断的漏、误诊率,尤其是在CTA诊断困难或病变不典型时,应联合TTE检查进行综合判断。

Objective：To evaluate the value of 320-row detector CT angiography（CTA）and transthoracic echocardiography（TTE）combined application in diagnosis of complicated congenital heart disease（CCHD）.Methods：The datas of CTA and TTE in 43 cases of CCHD proved by operation were analyzed retrospectively.All of malformations were divided into two groups：intracardiac malformations group and extracardiac malformations group,then the misdiagnosis and missed diagnosis rate of single CTA and CTA combined TTE were anglyzed.Results：The misdiagnosis and missed diagnosis rate of single CTA and CTA combined TTE were 13.8%and 2.3%,the misdiagnosis and missed diagnosis rate of single CTA and CTA combined TTE were 8.2% and 4.5%.The misdiagnosis and missed diagnosis rate of CTA and CTA combined TTE were 10.7% and 3.6% in diagnosis of all malformations.There was no statistically difference in diagnosis of extracardiac malformations,while statistically difference in diagnosis of intracardiac and all malformations,the combined application was superior to single CTA.Conclusion：The combined application of CTA and TTE can reduce the rate of the misdiagnosis and missed diagnosis of CCHD,especially the malformations who were hard to diagnose by CTA or atypical lesions should be comprehensive judgment by combined application with TTE.