64层CT在先天性心脏病诊断中的应用  

Application of 64-Multislice Spiral CT Angiography in Congenital Heart Disease

作　　者：萧毅[1] 田建明[1] 弓静[1] 李晓明[1] 林琳[1] 沈倩瑾[1] 孙高峰[1] 

机构地区：[1]第二军医大学附属长海医院影像科

出　　处：《中国医学计算机成像杂志》2007年第3期167-170,共4页Chinese Computed Medical Imaging

基　　金：领军人才培养基金(Ij06006);上海市卫生局科研基金(054098)~~

摘　　要：目的:探讨64层螺旋CT在先天性心脏病诊断中的应用价值。材料和方法:33例先天性心脏病患者,包括21例复合畸形、10例单纯室缺或房缺、2例主动脉弓离断;采用西门子Somatom Sensation Cardiac 64层螺旋CT进行检查,扫描参数:120kV,100-500mAs,64×0.6mm,以1.5-3.5ml/s的速率经肘静脉注入25-80ml非离子型对比剂,舒张末期重建0.75mm横断面图像,并在工作站上完成进行容积成像、最大密度投影、多层面重建及仿真内镜等。所有病例同期均进行了超声心动图及心血管造影检查,23例进行了手术治疗,10例进行了介入治疗。以手术结果为金标准,评价3种方法的诊断符合率。结果:23例患者手术显示累计畸形59处,CT正确诊断55处,诊断符合率93.2%;超声心动图正确诊断54处,诊断符合率91.5%;心血管造影正确诊断56处,诊断符合率94.9%;三者诊断符合率无统计学差异(x^2=0.63,P>0.05)。10例介入治疗者以血管造影为标准共有10处畸形,CT及超声均正确诊断,诊断符合率100%。结论:64层螺旋CT可逼真显现心脏大血管病理解剖结构,与超声、CAG相当,但受心率的影响较大。Purpose： The aim of the study was to evaluate the advantage and limitation of 64 - multislice spiral computed tomography（MSCT） in the diagnosis of congenital heart disease（CHD） . Materials and Methods： 33 patients （21 men, 12 women; mean age, 16 years± 9） with suspected underwent 64- slice CT （SOMATOM SENSATION CARDIAC 64 CT Siemens, Germany） . Of them, 21 had complex congenital hear disease, 10 had simple atrial septai defect and ventricular septai defect and 2 had aortic arch interruption . The following scan parameters were used： kV 120, mAs 100 - 500, configuration 64 × 0.6 mm, rotation time 0.33 s, a total of 25 or 80 ml intravenous contrast agent was injected at 1.5 - 3.5ml/s. For all patients, axial diastolil phase images were reconstructed with a slice thickness of 0.75 mm. The whole dataset was transferred for image analysis to a dedicated workstation （Second Wizard, Siemens） . The volume rendering technique （VRT）, multi - planar reformations （MPR） and maximum intensity projections （MIP） were used for the image evaluation. All the patients underwent echocardiography and angiography as correlation. 23 underwent operation therapy and 10 underwent interventionai therapy. Results were compared with those of surgery. Results： Totally 59 lesions were found in 23 patients by surgery. 55 of them were detected by MSCT; the rate of coincidence was 93.2%. 54 of them were detected by echocardiography; the rate of coincidence was 91.5%. 56 of them were detected by angiography; the rate of coincidence was 94.9%. There shows no difference between these three methods（x^2 = 0.63, P 〉 0.05）. Totally 10 lesions were found in 10 patients by surgery. All of them were correct detected by MSCT and Echocardiography, the rate of coincidence was100% .Conclusion： We suggest that 64- MSCT angiography can be performed as a noninvasive method in patients with CHD for the evaluation of coronary artery anatomy and anomalies and mediastinal vascular structures, equivalent with angiograph

关 键 词：X线计算机 体层摄影 先天性心脏病 血管造影 超声心动图 

分 类 号：R816.2[医药卫生—放射医学]