平板旋转血管造影及三维重建在先天性心脏病的应用  

Clinical applications of Three-dimensional image recon- struction using rotational digital angiography technique in congenital cardiopathy

作　　者：唐向周[1] 张群[1] 李国业[1] 成佛金[1] 谈文开[1] 

机构地区：[1]广东省人民医院广东省心血管病研究所心导管室,广东广州510080

出　　处：《国际医药卫生导报》2008年第6期26-31,共6页International Medicine and Health Guidance News

摘　　要：目的评价平板旋转血管造影及三维重建在先天性心脏病临床应用的价值。方法回顾了34例先天性心脏病患者的CT或MR、二维血管造影、旋转血管造影及三维重建影像学资料，并对其结果进行对比分析。结果行胸主动脉造影33例。其中肺动脉瓣闭锁主动脉侧支14例，法乐氏四联症主动脉侧支9例，动脉导管未闭8例，主动脉缩窄1例，主动脉弓畸形1例。行无注射对比剂房间隔堵闭器扫描重建1例。2例肺动脉瓣闭锁主动脉侧支，6例动脉导管未闭进行了介入治疗，侧支及动脉导管堵闭效果良好。旋转血管造影及三维重建和常规二维血管造影、CT及MR对比结果基本相符。旋转血管造影及三维重建相对常规二维血管造影更加快捷、方便，提供更多影像学信息。和CT或MR相比更能够清楚、直观、精确的显示检查区域的解剖结构，并且能够为介入治疗直接提供更多影像学资料。结论旋转血管造影及三维重建对先天性心脏病主动脉病变有较高的临床应用价值，提高诊断的准确性和介入治疗的安全性及疗效。Objective To evaluate the benefit of three-dimensional（3D） reconstruction images with rotational digital angiography technique for the clinical applications in congenital cardiopathy. Methods Conventional two-dimensional（2D） digital angiograpby, 3D reconstruction angiography images （use Philips Medical System Allura Xper FD20 ） and CT or MRI images. 34 cases of congenital cardiopathy were performed （14 men and 10 women; the age ranged from 2 to 16 years ,mean 8.7 years）. Result In this series of 34 cases of congenital cardiopathy, 10 cases pulmonary atresia and MAPVC, 4 cases tetralogy of Fallot,7 case patent ductus arteriosus, 1 case coarctation of aorta, 1 case aortic arch malformation, lcase membranous atrial septal defect were reconstituted without constrast medium. 1 case pulmonary atresia and MAPVCs, 6 cases patent ductus arteriosus were embolized. 33 cases of congenital cardiopathy were all correctly diagnosed by 3D rotational angiography , 2D digital angiography and CT or MR. 1 case was misdiagnosed as aneurysms at CTA ,but confirmed to be aortic arch malformation by 3D rotational angiography. The 3D rotational angiography is more advantageous than 2D digital angiography, and it provide more information of image. This technique enables better diagnosis for intracranial vascular lesion and visualization of complex vascular relationships and structure. Conclusion Three-dimensional （3D） reconstruction images with rotational digital angiography technique is a useful tool to study the congenital cardiopathy using less contrast agent and a lower radiation dose and shortening the examination process. It is can increase the diagnosis rate of main atery diseases. It is valuable for interventional procedure.

关 键 词：先天性心脏 病血管造影 数字化成像 图像处理 介入性 

分 类 号：R816[医药卫生—放射医学] R541[医药卫生—临床医学]