CT评估主动脉缩窄患儿主动脉弓发育情况

CT evaluation on aortic arch development in children with coarctation of aorta

目的通过CT评估主动脉缩窄(CoA)患儿主动脉弓的发育情况。方法回顾性分析47例经病理确诊的CoA患儿(CoA组)的CT资料,选取同期47例非心血管疾病患儿为对照组,测量2组肺动脉主干层面升主动脉最大内径(AOA)、横弓前部最大内径(D1)、横弓后部最大内径(D2)、峡部最大内径(D3)及降主动脉穿横膈最大内径(DA),计算D1/AOA、D2/AOA、D3/AOA及DA/AOA比值;比较2组上述参数的差异,分析2组上述参数与年龄的相关性。结果 CoA组D1/AOA、D2/AOA、D3/AOA均低于对照组(P均<0.001),2组DA/AOA差异无统计学意义(P=0.326);CoA组中,26例合并主动脉弓发育不良,其中11例D1/AOA≤0.6、15例D2/AOA≤0.5、13例D3/AOA≤0.4。2组D1/AOA、D2/AOA、D3/AOA及DA/AOA与年龄均无显著相关性(P均>0.01)。术后接受随访的5例主动弓发育不良患儿D1/AOA、D2/AOA或D3/AOA均大于先天性心脏病数据库分类标准。结论 CoA患儿常合并主动脉弓发育不良,且以横弓后部发育不良多见。

Objective To evaluate the development of aortic arch in children with coarctation of aorta (CoA)using CT.Methods CT data of 47 children with histopathologically proved CoA (CoA group)and 47 children with noncardiovascular diseases (control group)were retrospectively analyzed.The maximum internal diameter of ascending aorta (AOA),the proximal arch segment (D1),the distal arch segment (D2)and isthmus (D3),the maximum inner diameter of the descending aorta at the diaphragm (DA)were measured.The ratio of D1/AOA,D2/AOA,D3/AOA and DA/AOA were calculated.The differences of the above parameters were compared between the two groups,and the correlation between the above parameters and age were analyzed.Results The ratio of D1/AOA,D2/AOA and D3/AOA in CoA group were lower than those in control group (all P<0.01).There was no significant difference in DA/AOA between the two groups (P=0.3263).In CoA group,aortic arch dysplasia was found in 26 children,including 11 of D1/AOA≤0.6,15 of D2/AOA≤0.5and 13 of D3/AOA≤0.4.No obviously correlation was found between D1/AOA,D2/AOA,D3/AOA,DA/AOA and age in both two groups (all P>0.01).The ratio of D1/AOA,D2/AOA and D3/AOA greater than the congenital heart disease database classification standard in 5children with active arch dysplasia who were followed up.Conclusion Children with CoA often have aortic arch dysplasia,and dysplasia in the posterior arch is common.