电子束CT诊断主动脉-肺动脉间隔缺损的价值  

The value of electron-beam computed tomography (EBCT) in diagnosis of aortic-pulmonary septal defect

作　　者：祁晓鸥[1] 曹程[1] 戴汝平[1] 白桦[1] 陈瑶[1] 任力[1] 

机构地区：[1]中国医学科学院 中国协和医科大学阜外心血管病医院放射科,北京100037

出　　处：《中华放射学杂志》2006年第7期726-728,共3页Chinese Journal of Radiology

摘　　要：目的评价电子束CT(EBCT)对主动脉-肺动脉间隔缺损(APSD)及其合并畸形的诊断价值。方法7例APSD患者,年龄1-13岁。均行X线平片、超声心动图及EBCT检查。心电门控EBCT血管造影采用270 mg L／ml非离子型对比剂碘海醇,层厚1．5～3．0 mm。其中3例行心血管造影检查,2例有手术对照。将同一患者的各项影像学检查结果及手术所见进行比较并分析。结果7例主-肺动脉间隔缺损EBCT全部诊断,2例经手术证实;3例经心血管造影检查证实;超声心动图仅检出2例。同时,EBCT检查示4例合并右肺动脉起源异常、主动脉弓离断;5例合并动脉导管未闭,均经手术和(或)造影证实;超声心动图检查漏诊右肺动脉起源异常2例,漏诊主动脉弓离断2例;心血管造影漏诊动脉导管未闭l例。结论X线平片、超声心动图、心血管造影及EBCT综合影像诊断是必要的,作为无创性检查方法,EBCT在主动脉-肺动脉间隔缺损及其合并畸形诊断有重要价值。Objective To evaluate the valve of EBCT in diagnosis of aortic-pulmonary septal defect （APSD）. Methods There were 7 cases of APSD with age from 1-13 ages. In the all of 7 patients, the imaging studies included： x-ray plain film, ultrasound echocardiography and EBCT. ECG gating EBCT angiography were performed with 270 mg I/ml non-ionic contrast media and the slice thickness was 1.5-3.0 mm. Among them, 3 cases had cardiovascular angiography and 2 cases underwent surgical operation. Results The diagnosis of APSD were obtained in all cases by EBCT, out of which, 2 patients were proved＇by surgical operation, 3 cases were proved by angiocardiography. Only 2 cases with APSD were correctly diagnosed by echocardiography. Four cases with anomalous origin of right pulmonary artery and interruption of aortic arch were clearly detected by EBCT. Two cases with anomalous origin of right pulmonary artery and 2 cases with interruption of aortic arch were missed by echocardiography. One patient with patent ductus arteriosus was missed by angiocardiogTaphy. Conclusion APSD is an uncommon congenital heart disease. Its clinical diagnosis relies on imaging examinations, including X-ray plain film, ultrasound echocardiography, cardiovascular angiography and EBCT. According to this study, as a noninvasive method, EBCT has significant value in diagnosis of APSD and associated anomalies.

关 键 词：心脏缺损 先天性 体层摄影术 X线计算机 

分 类 号：R816.92[医药卫生—放射医学]