宝石能谱CT容积螺旋穿梭技术在儿童复杂先天性心脏病中的诊断价值

Value of volume helical shuttle of spectrum CT in diagnosing pediatric complex congenital heart diseases

目的探讨宝石能谱CT容积螺旋穿梭技术(CT-VHS)在儿童复杂先天性心脏病(complex congenital heart diseases,CCHD)诊断中的应用价值。方法选取42例CCHD患儿,行宝石能谱CT-VHS技术扫描及超声心动图(UCG)检查,所有患儿均经外科手术证实。对比两种检查方法对于儿童CCHD的心内畸形、心脏-大血管连接畸形、大血管及冠状动脉畸形的术前诊断价值。结果宝石能谱CT对心脏-大血管连接畸形诊断准确率(93.94%)高于超声心动图检查(72.73%),差异有统计学意义(P<0.05);宝石能谱CT对大血管及冠状动脉畸形诊断准确率(87.30%)高于超声心动图检查(69.84%),差异有统计学意义(P<0.05);超声心动图检查对儿童CCHD心内畸形诊断准确率(96.67%)高于宝石能谱CT(90.00%),差异无统计学意义(P>0.05)。结论宝石能谱CT-VHS技术有利于捕捉心脏不同节段显影最佳期相,能减少患儿因个体循环功能差异及心脏、大血管结构异常对图像质量的影响,有利于儿童CCHD的术前精确诊断,尤其在心脏-大血管连接畸形、大血管及冠状动脉畸形诊断中具有显著优势。

Objective To investigate the value of volume helical shuttle of spectrum CT(CT-VHS)in diagnosing children with complex congenital heart diseases(CCHD).Methods 42 surgically proved CCHD children,who underwent both the spectrum CT-VHS and ultrasonic cardiogram(UCG),were picked out from a succession of cases from July 2015 to July 2019.Detection rate of the two groups were compared in malformations of intra-cardiac structures,heart and large vascular connection,large vessels and coronary arteries(CA)construction.Results Detection rate of the spectrum CT-VHS significantly exceeded UCG in observation of heart and large vascular connection(93.94%vs 72.73%,P<0.05),together with large vessels and CA abnormality(87.30%vs 69.84%,P<0.05),whereas was slightly lower than UCG when identifying intra-cardiac structures with an insignificant P value(90.00%vs 96.67%,P>0.05).Conclusion Excelling at capture optimum phase of various ROI and decreasing impacts to image quality caused by individual circulation difference along with abnormality of heart and large vessels,the spectrum CT-VHS can be used as a superior preoperative approach to scrutinize CCHD,especially in detection of heart and large vascular connective malformations and large vessels and CA abnormality.