多排螺旋CT在永存动脉干诊断中的应用  

Application of mulidetector-row computed tomography in persistent truncus arteriosus

作　　者：陈艳[1] 马小静[1] 钟志林[1] 张雪莲[1] 彭志远[1] 陈鑫[1] 李炜[1] 熊青峰[1] 

机构地区：[1]武汉亚洲心脏病医院放射科,湖北武汉430022

出　　处：《实用放射学杂志》2011年第11期1663-1666,共4页Journal of Practical Radiology

摘　　要：目的探讨永存动脉干的多排螺旋CT诊断价值。方法回顾多排螺旋CT诊断的11例永存动脉干患者资料，11例均行超声心动图、64排或双源CT检查，其中8例行心血管造影测戢肺动脉压，并经手术治疗。将患者CT图像与经胸超声心动陶、手术探金（8例）所见对照分析。结果多排螺旋CT诊断永仔动脉下11例，根据VanPraagh分类法分型，其中A1型7例，A2型2例，A3型1例，A4型1例。2例病人合并冠状动脉起源异常。超声心动图诊断或提示永存动脉干9例。5例正确分型，4例未能正确分型，7例提示动脉瓣不同程度反流。误诊2例为肺动脉闭锁。A1型与A4型共8例患者行有心导管检查提示重度肺高压，并行动脉于修补手术，A2型与A3型未手术。结论多排螺旋CT可明确永行动脉干的诊断，超声心动图能良好的判断永存动脉干瓣膜病变，二者结合可提高对永存动脉于的无创诊断水平。Objective To evaluate the value of mulidelector-row computed tomography （MDCT） in diagnosis of persistent truncus arteriosus （PTA） . Methods Contrast enhanced MDCT scan and transthoracic echocardiography{TTE） were simulaneously performed in 11 cases with suspected PTA. Among them,eight cases underwent measurement of pressure of pulmonary artery by car- dioangiography（CAG） and operation. The results of MDCT were compared with that of TTE and surgery. Results In 1 1 cases with PTA diagnosed by MSCT,according to Van Praagh classification,there were type AI in 7 cases,type A2 in 2 cases,type A3 in one and type A4 in one. Two cases accompanied with coronary anomalies with TTE,the qualitative diagnosis of PTA in night cases was made,the correct classification in five cases,but 4 cases not, and seven cases were showed with valvular regurgitation,2 cases were misdiagnosis as puhnonaty atresia. 8 cases with type A1 and A2 were diagnosed with serious pulmonary hypertension by CAG,and underwent surgery. Conclusion PTA can be definitively diagnosed by MDCT, TTE can show the valve dysfunction well, MDCT in combination with TTE can improve the diagnosis of PTA.

关 键 词：心脏 永存动脉干 体层摄影术 X线计算机 

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