MSCT血管成像技术在主动脉缩窄诊断中的临床价值  

The clinical value of multi-slice spiral CT angiography in the diagnosis of aortic coarctation

作　　者：姚凤明[1] 戴闽晔[1] 任峰[1] 付峰[1] 李晖[1] 

机构地区：[1]宁波大学附属李惠利医院放射科,浙江315041

出　　处：《放射学实践》2012年第4期402-405,共4页Radiologic Practice

摘　　要：目的:评价MSCT血管成像(MSCTA)技术在主动脉缩窄伴心脏畸形诊断中的应用价值。方法:11例主动脉缩窄患者行MSCT平扫和增强扫描,将获得的原始数据进行多平面重组(MPR)、最大密度投影(MIP)、容积再现(VR)及仿真内境(VE)等后处理。所有患者术前均行超声心动图检查,对照手术结果及超声心动图,分析MSCTA在诊断主动脉缩窄伴心内畸形中的优缺点。结果:11例患者心内心外畸形共35处,MSCTA共诊断26处(诊断符合率74.3%),其中心外畸形19处(诊断符合率95%),漏诊1处动脉导管未闭,诊断心内畸形7处(诊断符合率46.7%),漏诊2例房间隔缺损和6例瓣膜病变共8处畸形;超声心动图共诊断畸形29处(诊断符合率82.9%),其中诊断心外畸形14处(诊断符合率70%),漏诊主动脉缩窄5例和肺静脉瘤样扩张1例,诊断全部心内畸形(诊断符合率100%)。结论:MSCTA能直观地显示主动脉缩窄的特异征象,明确病变的部位、类型、侧枝血管情况,对于诊断、选择治疗方法、观察术后疗效及随访具有较高的临床应用价值。MSCTA和超声心动图的联合应用是诊断心内心外复杂畸形的最佳方法。Objective：To evaluate the clinical value of multi-slice spiral CT angiography（MSCTA） in the diagnosis of cardiac malformation associated with aortic coarctation（CoA）.Methods：11 cases of CoA underwent pre-and post-contrast enhanced MSCT,and the original data were post-processed with multi-planar reformation（MPR）,maximum intensity projection（MIP）,volume rendering（VR） and virtual endoscopy（VE） techniques.All of the patients were examined by echocardiography before surgery.The results of MSCTA were correlated with that of surgery and echocardiography,and the advantages and disadvantages of MSCTA in the diagnosis of CoA associated with cardiac malformation were analyzed.Results：Totally 35 extra-/intra-cardiac malformations were detected in those 11 patients.26 lesions were diagnosed by MSCTA with the accuracy rate as 74.3%,including 19 extra-cardiac malformations（accuracy rate,95%）,however,1 case of patent ductus arteriosus was missed;7 intra-cardiac malformations were diagnosed（accuracy rate,46.7%）,and 8 malformations were missed,with 2 cases of atrial septal defect and 6 valvular lesions.29 malformations were diagnosed by echocardiography with the accuracy rate as 82.9%,including 14 extra-cardiac malformations（accuracy,70%）,6 malformations were missed,in which 5 cases of CoA and 1 case of pulmonary venous ectasia,however,all intra-cardiac malformations were diagnosed with the accuracy rate as 100%.Conclusion：The specific features of CoA could be directly displayed by MSCTA,the position,type and the status of collateral vessels could be clearly identified.MSCTA provides significant clinical values in the diagnosis,selection of treatment,observing of curative effect after-surgery and follow-up.MSCTA in combination with echocardiography is the best approach in the diagnosis of the complicated intra-and extra-cardiac malformations.

关 键 词：主动脉缩窄 血管成像术 体层摄影术 X线计算机 后处理 超声心动图 

分 类 号：R816.2[医药卫生—放射医学]