CT对主动脉缩窄患儿主动脉弓发育状况的评估价值

Value of CT in Evaluating the Development of Aortic Arch in Children with Coarctation of Aorta

目的CT检查对主动脉缩窄患儿主动脉弓发育状况评估可以为临床救治提供依据。方法选择2016年4月1日-2020年5月31日在某两家医院就诊的主动脉缩窄患儿32例为观察组,选择同期就诊的患儿32例为研究对照。两组均进行临床CT检查,检测两组的肺动脉主干层面DA、D3、D1、AOA、D2等参数指标变化;比较两组DA/AOA、D3/AOA、D2/AOA、D1/AOA等参数指标变化;评估主动脉缩窄患儿主动脉弓发育不良发生情况及与D3/AOA、D2/AOA、D1/AOA、DA/AOA等指标情况的相关性。结果观察组D3/AOA为0.51±0.09、D2/AOA为0.55±0.08、D1/AOA为0.69±0.09指标与对照组(0.76±0.13,0.80±0.11,0.88±0.12)相比下降,差异有统计学意义,P<0.05;主动脉缩窄合并主动脉弓发育不良者26例(81.25%),主动脉缩窄发生主动脉弓发育不良与D3/AOA、D2/AOA、D1/AOA等指标具有显著的相关性,P<0.05。结论主动脉缩窄患儿多发生主动脉弓发育不良,以横弓后部发育不良多见,CT检查对主动脉缩窄患儿主动脉弓发育状况评估具有重要的临床价值。

Objective To investigate the clinical value of CT examination in evaluating the development of aortic arch in children with coarctation of aorta.Methods From April 1,2016 to May 31,2020,32 children with coarctation of aorta who were treated in two hospitas were selected as the observation group,and 32 children with cardiovascular or chest enhancement instead of abnormal aorta were selected as the study control group.Clinical CT examination was performed in both groups.The maximum diameter of descending aorta passing through DA,D3,D1,AOA and D2 were measured at pulmonary artery trunk level.The changes of DA/AOA,D3/AOA,D2/AOA,D1/AOA and other parameters were compared between the two groups;the incidence of aortic arch dysplasia in children with aortic coarctation and its correlation with D3/AOA,D2/AOA,D1/AOA and DA/AOA were evaluated.Results The indexes of D3/AOA(0.51±0.09),D2/AOA(0.55±0.08)and D1/AOA(0.69±0.09)in the observation group were significantly lower than those in the control group(0.76±0.13,0.80±0.11,0.88±0.12)(P<0.05);There were 26 cases(81.25%)with aortic coarctation and aortic arch dysplasia.The incidence of aortic arch dysplasia was significantly correlated with D3/AOA,D2/AOA,D1/AOA(P<0.05).Conclusion Children with coarctation of aorta often have aortic arch dysplasia,and dysplasia of the posterior transverse arch was more common.CT examination has important clinical value in evaluating the development of aortic arch in children with coarctation of aorta.