64排螺旋CT对肺血减少型先天性心脏病幼猪未成熟肺血管发育的评估作用  

The Application of 64-slice CT in Evaluation the Immature Pulmonary Vascular in the Porcine Model of Congenital Heart Defect with Decreased Pulmonary Blood Flow

作　　者：王康武[1] 刘学刚[1] 刘戈[1] 张雷[1] 王安生[1] 宋超[1] 张俊祥[2] 

机构地区：[1]蚌埠医学院第一附属医院胸心外科,233004 [2]蚌埠医学院第一附属医院CT室,233004

出　　处：《临床放射学杂志》2011年第5期742-745,共4页Journal of Clinical Radiology

基　　金：安徽省高等学校省级重点自然科学研究项目(KJ2009A74)

摘　　要：目的采用一种新颖的Hybrid方法建立肺血减少型先天性心脏病幼猪动物模型,评价64排螺旋CT对肺血减少型先天性心脏病幼猪未成熟肺血管发育评估的应用价值。材料与方法采用生后1~2个月的实验用小型幼猪,共20只。随机分为二组。假手术组（S组,n=4）：右进胸微创小切口制成一过性肺血减少;手术组（T组,n=16）：右进胸微创小切口,经右心房表面送入自制扩张器行人工房间隔造口术,并且肺动脉Band ing环缩,使跨环缩处压差为30~50 mmHg。T组于术后1个月行64排螺旋CT扫描及超声心动图检查,两者图像均能清晰显示肺动脉的发育情况者定义为阳性,并作定量测量;不能清晰显示肺动脉发育情况或明确判断肺动脉未发育者均定义为阴性,不作定量测量。术后2个月进行手术探查测量证实,对比其结果并进行统计学分析。结果对于肺动脉的定性诊断,64排螺旋CT较心脏超声优越（诊断敏感度：前者91.4%,后者45.7%）;肺动脉的测量,64排螺旋CT与手术探查之间有良好的相关关系（右肺动脉r=0.91,左肺动脉r=0.86）。结论 64排螺旋CT可以应用于肺血减少型先天性心脏病幼猪肺血管发育的评估,对临床准确地判断肺血管发育不良的病变程度具有较高的准确性。Objective Using a novel Hybrid method to establish Porcine model of congenital heart disease with diminutive pulmonary blood,to evaluate the value of 64-slice CT in judging the immature pulmonary vascular.Materials and Meth-ods Choose twenty piglets with about one to two-month-old,which were exclusively for experiment used.The piglets were randomly divided into two groups：sham operation group（group S,n=4）,small incisions on the right chest,produced a transient reduction in pulmonary blood;operation group（group T,n=16）：small incisions on the right chest,did artificial room septostomy creation by self-dilators which were delivered into the surface of the right atrium and controlled pulmonary artery banding to generate a systolic pressure gradient at pressure of 30-50 mmHg.After one month group T carried out 64-slice CT scanning and echocardiography.Both the two images could clearly show the development of pulmonary arteries which were defined as positive,which could make quantitative measurements;they did not clearly show the development condition of pulmonary arteries or made conclusion that no development of pulmonary artery which were defined as negative,which could not make quantitative measurement.To measured and confirmed after two month surgical exploration,then compared the results and analyzed statistically.Results For the qualitative diagnosis of pulmonary artery,64-slice CT is superior compared with echocardiography（diagnostic sensitivity：the former was 91.4%,the later was 45.7%）;pulmonary artery measurements,64-slice CT and surgical exploration had a good correlation.（RPA r=0.91,LPA r=0.86）.Conclusion The 64-slice CT can be applied to assess the development of pulmonary vascular of porcine model of congenital heart disease with diminutive pulmonary blood,and it has a high degree of accuracy in judgement of the clinical pulmonary vascular dysplasia lesions.

关 键 词：体层摄影术 X线计算机 先天性心脏病 肺血流减少 动物模型 猪 肺血管 

分 类 号：R816.2[医药卫生—放射医学]