128层螺旋CT在法洛四联症术前评估中的应用价值  

Application value of 128-slice spiral computed tomography in preoperative assessment on tetralogy of fallot

作　　者：金晶[1] 郑穗生[1] 王龙胜[1] 赵红[1] 姚文君[1] 管松[1] 

机构地区：[1]安徽医科大学第二附属医院放射科,合肥230601

出　　处：《安徽医学》2010年第11期1283-1286,共4页Anhui Medical Journal

基　　金：安徽省临床医学应用技术项目(编号05A017)

摘　　要：目的探讨128层螺旋CT(在法洛四联症术前评估的临床应用价值。方法回顾性分析经临床手术证实的18例患者CT血管造影资料,并用多平面重建(MPR)、最大密度投影(MIP)及容积再现(VR)进行图像重建。所有病例均有超声心动图(ECHO)对照。结果手术证实的心血管畸形112处,128层螺旋CT的诊断准确率为95.54%,明显高于ECHO的诊断准确率77.68%(P<0.01)。对手术证实的18例小儿法洛四联症,128层螺旋CT的诊断准确率达到100%,ECHO正确诊断17例,诊断率为99.44%,两者差异无统计学意义(P>0.05)。128层螺旋CT对法洛四联症伴发畸形的诊断准确率为86.11%,优于ECHO的52.78%(P<0.01)。18例患者手术证实肺动脉狭窄65处,128层螺旋CT诊断50例,正确率为76.92%,ECHO诊断46例,正确率为70.77%,差异无统计学意义(P>0.05);在左、右肺动脉狭窄检出,128层螺旋CT优于ECHO,差异有统计学意义(P<0.05)。结论 128层螺旋CT对法洛四联症术前评估及手术方案的制定具有重要价值。Objective To explore the application value of 128-slice spiral computed tomography in preoperative assessment on Tetralogy of Fallot（TOF）.Methods The 128-slice spiral CT for cardiovascular angiography of 18 clinical operation confirmed patients are reviewed. Multiplannar Reformation （MPR） ,maximum intensity projection （MIP） and volume render （VR） were used to reconstruct the images.ECHO was performed on all patients.Results The operations conformed 112 malformations.According to the surgical operation ,the diagnostic accuracy of 128-MSCT and ECHO was 95.54 % and 77.68 % ,respectively （χ^2 = 15.395,P〈0.01）.In diagnosing 18 TOFs ,the diagnostic accuracy of 128-MSCT was 100 %,17 of them were detected by ECHO,the diagnostic accuracy of was 99.44%There was no difference between these two methods（χ2 = 0.51,P〉 0.05） .In diagnosing TOF accompanying malformations,the accuracy of 128-slice spiral CT and ECHO was 86.11 % and 52.78 %,respectively （χ^2 = 9.425,P〈0.01）.The findings of 128-MSCT in pulmonary arteries stenosis in tetralogy of fallot were analyzed retrospectively,and the results were compared with those of ECHO and sugery.18 cases of TOF surgery had discovered 65 lesions. 50 of them were detected by MSCT;the diagnostic accuracy was 76.92%,46 of them were detected by ECHO;the diagnostic accuracy was 70.77%. There was no difference between these two methods（χ^2 =0.637,P〉0.05）;In the left and right artery stenosis detection,128-slice spiral CT is better than ECHO The difference between these had statistical significance.Conclusion 128-slice spiral CT is extremely valuable for Preoperative assessment and planning the operative procedure for the patients with TOF.

关 键 词：法洛四联症 体层摄影术 X线计算机 超声心动图 

分 类 号：R726.5[医药卫生—儿科] R816.92[医药卫生—临床医学]