CT在房间隔缺损合并肺静脉异位引流中的诊断价值

The diagnostic value of CT in atrial septal defect complicated with anomalous pulmonary venous connection

目的:评价CT对房间隔缺损(ASD)合并肺静脉异位引流(APVC)的诊断价值。方法:回顾性分析我院CT检查的24例ASD合并APVC的病例,观察房间隔缺损的位置、大小,异位肺静脉引流的位置、形态及其异位连接,并与经胸心动超声(TTE)比较,以手术或心导管造影所见为参考标准,评价CT检查诊断的准确性。结果:24例ASD合并APVC的病例中,腔静脉窦型房缺14例,二孔型房缺9例,无顶冠状静脉窦型房缺1例;肺静脉异位引流中完全性肺静脉异位引流4例,其中心上型3例,心脏型1例,部分性肺静脉异位引流20例,其中心上型8例,心脏型12例。CT的诊断准确性为100%,TTE的诊断准确性为75%(18/24)。结论:CT在ASD合并APVC的诊断中具有很高的价值,对临床诊断和手术方案的制订起到重要作用。

Objective:The purpose of this study was to evaluate the diagnostic value of CT in atrial septal defect(ASD)complicated with anomalous pulmonary venous connection(APVC).Methods:24 cases with ASD complicated with APVC who underwent CT examination were retrospectively analyzed.The location and size of the ASD,and the anatomy of pulmonary veins,including the position and site of anomalously draining pulmonary veins observed.All cases were verified by means of surgery or cardiac catheterization,with which as reference,the diagnostic accuracy of CT was compared with ultrasound transthoracic echocardiography(TTE).Results:Among the 24 patients,there were 14 cases with superior or inferior sinus venousus defects,9 cases with ostium secundum defects,one patient with coronary sinus defect.There were 4 cases with total APVC,including 3 cases of supra-cardiac,one case of intra-cardiac,and 20 cases with partially APVC,including 8 cases of super-cardiac and 12 cases of intra-cardiac.The diagnostic accuracy of CT was 100%,and that of TTE was 75%(18/24).Conclusion:CT is a useful technique for the diagnosis of ASD complicated with APVC,and plays an important role in the clinical diagnosis and surgical plan.