多层螺旋CT血管成像诊断主动脉离断和缩窄的初步应用  

Value of Multi-slice Spiral CT Angiography in the Diagnosis of Interrupted Aortic Arch and Coarctation of Aorta

作　　者：喻杰[1] 韩萍[1] 谢明星[2] 梁波[1] 史河水[1] 雷子乔[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022 [2]华中科技大学同济医学院附属协和医院超声影像科,武汉430022

出　　处：《放射学实践》2008年第3期271-274,共4页Radiologic Practice

摘　　要：目的:探讨多层螺旋CT血管成像(MSCTA)对主动脉弓离断(IAA)和缩窄(CoA)的诊断价值,并与超声检查进行比较。方法:回顾性分析11例术前临床疑诊IAA和CoA患者的MSCTA和超声检查结果,并与手术结果进行对比分析。11例中IAA3例,CoA7例,主动脉折曲1例;合并动脉导管未闭(PDA)5例,室间隔缺损(VSD)4例。结果:11例中MSCTA诊断IAA3例,疑诊1例;诊断CoA6例、假性主动脉缩窄1例。超声检出IAA2例,其中1例为疑诊,漏诊IAA1例;诊断CoA8例,其中1例为误诊。MSCTA检出VSD2例,PDA3例;超声检出VSD5例,PDA6例。MSCTA可较好显示主动脉离断和缩窄的部位、程度及其合并的心内外畸形和侧支循环的情况。结论:MSCTA是诊断主动脉离断和缩窄的重要方法,为临床提供直观参考,结合超声检查可提高对合并心内畸形的诊断。Objective：To evaluate the value of multi-slice spiral CT angiography （MSCTA） in the diagnosis of interrupted aortic arch （IAA） and coarctation of aorta （CoA）,and to compare the MSCTA with the results of echocardiography （ECG）. Methods：The preoperative MSCTA and echocardiography of 11 cases with clinically suspected IAA and CoA were retrospectively analyzed and correlated with the surgery findings. There were 3 cases of IAA, 7 cases of CoA and one case of aortic kink;5 cases were combined with patent ductus arteriosus （PDA） and 4 cases with ventricular septal defect （VSD）. Results：Of the 11 patients having MSCTA,3 cases of IAA were definitely diagnosed,as well as 6 patients of CoA and 1 patient of pseudo-CoA were detected, 1 patient was suspected of having IAA. 2 patients of IAA were detected by ECG, 1 of them was just suspected of having IAA before surgery, 1 patient with IAA was missed by ECG. 8 patients were diagnosed as CoA by ECG,but one was mis-diagnosed. 2 patients with VSD and 3 patients with PDA were detected by MSCTA;and 5 patients with VSD and 6 patients with PDA were diagnosed by ECG. The location and severity of aortic interruption/stenosis, and the combined intra-/extra-cardiac malformation as well as collateral circulation of IAA and CoA could be more clearly revealed by MSCTA. Conclusion：MSCTA is a valuable technique for the diagnosis of IAA and CoA, which provided an objective reference for clinical approach. Diagnostic accuracy of combined cardiac malformation could be improved as ECG was used in addition.

关 键 词：体层摄影术 X线计算机 血管造影术 超声心动描记术 多普勒 心脏缺损 先天性 主动脉疾病 

分 类 号：R816.2[医药卫生—放射医学]