双源CT前瞻性心电门控技术在小儿主动脉缩窄诊断中的应用  

The application of prospective echocardiography-gated dual-source CT in children with aortic coarctation

作　　者：聂佩[1] 王莉[2] 王锡明[1] 程召平[1] 段艳华[1] 纪晓鹏[1] 乔红艳[1] 乌大尉[1] 晁宝婷[1] 杨世锋[1] 

机构地区：[1]山东大学医学院山东省医学影像学研究所CT室,济南250021 [2]山东省立医院PET—CT诊疗中心

出　　处：《中华放射学杂志》2012年第5期401-404,共4页Chinese Journal of Radiology

摘　　要：目的探讨双源CT（DSCT）前瞻性心电门控技术在小儿主动脉缩窄诊断中的价值。方法对16例临床怀疑为主动脉缩窄的患儿行DSCT前瞻性心电门控心胸联合血管成像及心脏彩色多普勒血流显像（CDFI）检查。以手术或DSA结果为标准，采用X。检验比较DSCT和CDFI的诊断准确率。结果DSCT诊断主动脉缩窄16例，其中伴房间隔缺损（ASD）4例、室间隔缺损（VSD）9例、大动脉转位1例、主动脉弓发育不良3例、动脉导管未闭（PDA）7例、冠状动脉起源异常1例、支气管动脉扩张1例。CDFI诊断主动脉缩窄15例，主动脉弓离断1例，伴ASD4例、VSD9例、二叶型主动脉瓣（BAV）2例、大动脉转位1例、主动脉弓发育不良2例、PDA7例、支气管动脉扩张1例，未发现冠状动脉起源异常。与手术或DSA结果对照：DSCT和CDFI诊断准确率分别为97．2％（140／144）、97．9％（141／144），两者差异无统计学意义（X2=0．00，P〉0．05），DSCT和CDFI诊断敏感度均为93．2％（41／44），特异度分别为99．0％（99／100）和100．0％（100／100）。DSCT前门控平均有效辐射剂量为0．42mSv。结论DSCT前瞻性心电门控技术是诊断小儿主动脉缩窄的首选检查方法。Objective To investigate the value of prospective ECG-gated dual-source CT （DSCT） in the diagnosis of coarctation of aorta （ CoA ） . Methods Sixteen patients clinically suspected of CoA underwent prospective ECG-gated DSCT angiography and color Doppler flow imaging （CDFI）. The diagnostic accuracy of DSCT and CDFI were compared according to the results of operation or DSA. The non- parametric chi-square test was used for the statistics. Results Sixteen patients were diagnosed as CoA by DSCT, 4 were complicated with artial septal defect （ASD）, 9 with ventricular septal defect （VSD）, 1 with transposition of the great arteries, 3 with dysplasia of aortic arch, 7 with patent ductus arteriosus （PDA）, 1 with abnormal origin of the coronary artery, 1 with bronchus artery dilation. Fifteen patients were diagnosed as CoA by CDFI, 1 was diagnosed as interruption of aortic arch. Four were complicated with ASD, 9 with VSD, 2 with bicuspid aortic valve （ BAV）, 1 with transposition of the great arteries, 2 with dysplasia of aortic arch, 7 with PDA, 1 with bronchus artery dilation. Abnormal origin of the coronary artery was not found. The diagnostic accuracy of DSCT and CDFI were 97. 2% （140/144） and 97. 9% （141/144） respectively, there was no significant difference （ X2 = 0. 00, P 〉 0. 05 ）. The sensitivity of DSCT and CDFI were both 93.2% （41/44）, the specificity were 99. 0% （ 99/100 ） and 100. 0% （ 100/100）. The mean effective radiation dose was 0.42 roSy. Conclusion Prospective ECG-gated DSCT is a good imaging technique for the diagnosis of aortic eoarctation in children.

关 键 词：主动脉狭窄 体层摄影术 X线计算机 超声心动描记术 多普勒 彩色 血管 造影术 

分 类 号：R72[医药卫生—儿科] R816[医药卫生—临床医学]