先天性主动脉缩窄合并心血管发育畸形的综合影像学诊断  

Imaging diagnosis of congenital aortic coarctation accompanied with cardiovascular malformation

作　　者：赵宏亮[1] 宦怡[1] 郑敏文[1] 魏梦绮[1] 

机构地区：[1]第四军医大学西京医院放射科,陕西西安710032

出　　处：《实用放射学杂志》2012年第1期26-28,53,共4页Journal of Practical Radiology

基　　金：陕西省攻关项目[编号：2007K12-02（2）];西京医院重大课题项日（编号：XYZT08210）.

摘　　要：目的对比评价双源CT（DSCT）、经胸超声心动图（TTE）、磁共振成像（MRI）及心血管造影（ACG）检查在诊断先天性主动脉缩窄的价值。方法经手术证实60例患有先天主动脉缩窄的患者，术前均做过DSCT、TTE检查，其中17例做过选择性造影检查．7例做过MRI检查，回顾性分析归纳其影像学特点。结果DSCT及ACG显示弓部缩窄手术符合率为100％．TTE手术符合率仅为46．6％，MRI手术符合率为57％，DSCT诊断的手术符合率等同于ACG。合并畸形DSCT诊断的手术符合率为89．6％，TTE诊断的手术符合率为85．9％，MRI诊断手术符合率为100％．ACG诊断的手术符合率为100％。TTE诊断心室内畸形手术符合率明显高于DSCT检查，诊断心外大血管畸形手术符合率低于DsCT及ACG。结论在主动脉缩窄及合并心室内畸形诊断上，’FTE检查结合DSCT检查手术符合率达100％，可取代有创的ACG检查。MRI虽优越性明显，但由于扫描时间长，小儿难以配合等因素，在主动脉缩窄及合并心室内畸形诊断上有一定局限性。Objective To evaluate the value of dualsource CT（DSCT）, thransthoraeic echocardiography （TTE）, magnetic reso nance imaging（MRI）,and angiocardiogarphy（ACG） in diagnosing congenital aortic coarctation. Methods All 60 patients with congenital aortic coarctation confirmed by operation underwent DSCT and TTE, 17 and 7 of 60 patients underwent ACG and MRI simultaneously, respectively. The imaging appearances of congenital aortic coarctation at imaging examinations were analyzed retrospectively. Results In comparison with the results of operation,the accurate rates in revealing coarctation of were 100% by DSCT and ACG, 46.6% by TTE and 57% by MRl,while aortic arch in revealing accompanied cardiovascular malformation were 89.6% and 85.9% respectively by DSCT and TTE, 100%by MRI and ACG. The accurate rate in diagnosing cardiac ventricular malformation by TTE was obviously high than DSCT, but in diagnosing extracardiac great vascular malformation was lower by TTE than DSCT and ACG. Conclusion Because the sensitivity of TTE combined with DSCT in diagnosing congenital aortic coarctation is 100 %, ,it will be a potential means to replace ACG.

关 键 词：心脏 主动脉缩窄 体层摄影术 X线计算机 心脏超声 心血管造影 磁共振成像 

分 类 号：R543.1[医药卫生—心血管疾病] R814.4[医药卫生—内科学]