64层螺旋CT在先天性主动脉缩窄和主动脉弓离断诊断中的价值  

The Value of 64--slice Spiral CT in Diagnosis of Congenital Coarctation of Aorta and Interrupted Aortic Arch

作　　者：杨志浩[1] 高剑波[1] 郭华[1] 岳松伟[1] 张永高[1] 刘杰[1] 

机构地区：[1]郑州大学第一附属医院放射科,河南郑州450052

出　　处：《实用放射学杂志》2011年第2期202-205,共4页Journal of Practical Radiology

摘　　要：目的探讨64层螺旋CT（MSCT）在先天性主动脉缩窄（COA）和主动脉弓离断（IAA）诊断中的应用价值。方法对21例经手术或DSA证实的COA（18例）和IAA（3例）影像学表现进行回顾性分析，探讨64层螺旋CT增强扫描方法及后处理对其病理分型与合并畸形的诊断价值。结果（1）18例COA术前CT均诊断正确，诊断准确率100％。对合并的畸形，如单心室、动脉导管未闭（PDA）、主动脉骑跨、大动脉转位、体肺侧枝循环术前CT均正确诊断，有2例二尖瓣狭窄、1例主动脉瓣狭窄、2例肺动脉高压（PH）、1例室间隔缺损（VSD）及1例房间隔缺损（ASD）漏诊。（2）CT诊断3例IAA，均为A型，均合并有VSD、PDA及PH，除1例ASD漏诊外其他畸形与手术完全符合。结论64层螺旋CT作为一种无创性血管造影技术，对于COA和IAA及其合并的其他畸形，具有重要的诊断价值，因而可作为患者检查的首选。Objective To evaluate the clinical diagnostic value of 64--slice spiral CT （MSCT） in congenital coarctation of aorta （COA） and interrupted aortic arch （IAA）. Methods Eighteen cases of COA and three cases of IAA confirmed by surgery or DSA were retrospectively analyzed. CT angiography and image recontruction including MPR, MIP, CPR, VR were performed at GE 64 MSCT. Results （ 1 ） Eighteen patients with COA were diagnosed correctly by MSCT and proved by surgery or DSA. For the combined malformations, such as single ventricle, patent ductus arteriosus （PDA}, overriding aorta, transposition of conducting arteries, and collateral circulation were all correctly diagnosed,while 2 cases of mitral stenosis（MS）, 1 case of aortic stenosis, 2 cases of pulmonary arterial hypertension（PH） , 1 case of ventricular septal defect（VSD） and 1 case of atrial septal defect（ASD） were missed diagnosis by MSCT. （2） Three patients with IAA were diagnosed as type A by MSCT, which were all in combination with VSD, PDA and PH. Except one case with ASD was missed, the diagnosing accordance rate of combined malformations was 100%. Conclusion As an excellent non--invasive diagnosis modality in diagnosing COA, IAA and combined malformations, 64--slice spiral CT provides an objective reference for clinical approach, and can be used as a method first choice in its diagnosis.

关 键 词：心脏 体层摄影术 X线计算机 先天性心脏病 

分 类 号：R541.1[医药卫生—心血管疾病] R814.42[医药卫生—内科学]