双源CT在单心室诊断和分型中的应用

Application of Dual Source CT in the Diagnosis and Classification of Single Ventricle

目的探讨双源CT对单心室(SV)诊断、分型的价值。方法回顾性分析10例经双源CT诊断并经手术、超声等方法证实为SV的病例资料。通过节段分析法分析内脏-心房关系、心房-心室连接、心室-大血管连接等内容,对SV进行分型并确定解剖畸形。结果 10例SV均经双源CT正确诊断,超声诊断正确9例。双源CT对10例SV按心室形态结构分型分为A型8例、B型1例、D型1例,按主动脉与肺动脉位置关系分型分为Ⅰ型1例、Ⅱ型4例、Ⅲ型5例。双源CT确诊合并其他解剖畸形共19种55处。6例接受手术治疗的病例与双源CT结果对比漏诊永存动脉干、下腔静脉肝段缺如、房间隔缺损、动脉导管未闭各1例,误诊房间隔缺损1例。结论双源CT对SV诊断及分型具有重要意义,对外科手术具有重要指导价值。

Objective To investigate the value of dual source CT in the diagnosis and classification of single ventricle.Methods The clinical materials of 10 patients with single ventricle diagnosed by dual source CT and confirmed by surgery or echocardiography were analyzed retrospectively. The relationship between visceral and atrium,atrium ventricle connection,ventricular vascular connection based on the section analysis were studied. The SV were classified and the anatomic deformities were identified. Results All of the 10 cases of SV were all diagnosed by dual source CT accurately,while only 9 cases were accurately diagnosed by echocardiography. 10 cases were classified by dual source CT according to the morphology of the ventricular type as 8 cases of type A,1 case of type B and 1 case of type D. While all the 10 cases were classified according to the location of pulmonary artery and aorta,1 case was of type Ⅰ,4 cases of type Ⅱ and 5 cases of type Ⅲ. 55 concomitant anatomic deformities of 19 kinds were diagnosed by dual source CT. Some deformities were missed,and these comprised persistent truncus arteriosus,inferior hepatic vein segment absence,atrial septal defect and patent ductus arteriosus for 1 case each. There was a misdiagnosis of atrial septal defect in 1 case. 6 cases received both surgical treatment and dual source CT. Conclusion Dual source CT has great significance in accurate diagnosis and classification of SV. Thi can provide important guidance for surgical treatment.