4D-CTA在ASD、VSD介入术前检查评估中的价值分析

Analysis of the Value of 4D-CTA in the Evaluation of ASD and VSD before Interventional Surgery

本研究探讨320排螺旋CT心脏四维容积动态成像(4D-CTA)在房间隔缺损(ASD)和室间隔缺损(VSD)微创介入术前检查中的应用价值。选取行ASD和VSD介入封堵术的66例患者作为研究对象,所有患者手术前均接受4D-CTA及二维超声心动图(2D-TTE)检查。对比4D-CTA、2D-TTE两种方法测定的ASD参数、VSD参数、左心功能参数差异,并分析4D-CTA、2D-TTE测定的ASD参数、VSD参数与封堵器腰部直径的相关性。35例ASD患者,4D-CTA测定的ASD最大直径、ASD最小直径、房间隔总长度、EDV、ESV、SV值与2D-TTE测定结果比较,差异无统计学意义(P>0.05),但EF值大于2D-TTE测定结果(P<0.05)。31例VSD患者,4D-CTA测定的VSD最大直径、VSD最小直径、室间隔总长度、EDV、ESV、SV、EF值与2D-TTE测定结果比较,差异无统计学意义(P>0.05)。4D-CTA测定的ASD、VSD最大直径与封堵器腰部直径相关性r值均大于2D-TTE的。4D-CTA能在术前更加准确地测定ASD、VSD缺损范围,同时评估患者术后左心功能,4D-CTA术前测定对于指导封堵器的选择方面更具优势。

This study investigated the application value of 320-slice spiral CT cardiac four-dimensional volume dynamic imaging(4D-CTA)in the preoperative examination of atrial septal defect(ASD)and ventricular septal defect(VSD)minimally invasive intervention.66 patients who underwent ASD and VSD interventional occlusion were selected as the research subjects.All patients received 4D-CTA and two-dimensional echocardiography(2D-TTE)check.The differences of ASD parameters,VSD parameters and left ventricular function parameters measured by 4D-CTA and 2D-TTE were compared,and the correlation between ASD parameters and VSD parameters measured by 4D-CTA and 2D-TTE and the waist diameter of the occluder was analyzed.In 35 patients with ASD,there was no significant difference in ASD maximum diameter,ASD minimum diameter,total atrial septum length,EDV,ESV,and SV values measured by 4D-CTA and 2D-TTE(P>0.05),but EF value was greater than that of 2D-TTE assay(P<0.05).In 31 patients with VSD,there was no significant difference between the maximum diameter of VSD,the minimum diameter of VSD,total length of ventricular septum,EDV,ESV,SV,and EF measured by 4D-CTA and 2D-TTE(P>0.05).The correlation r value of ASD,VSD maximum diameter and occluder waist diameter determined by 4D-CTA was greater than that of 2D-TTE.4D-CTA can more accurately measure the extent of ASD and VSD defect before operation,and at the same time evaluate the left ventricular function of patients after operation.4D-CTA preoperative measurement has more advantages in guiding the selection of occluder.