上腔静脉窦型房间隔缺损的多层螺旋CT诊断  

Imaging of superior sinus venosus atrial septal defect by multi-slice CT

作　　者：李世国[1] 蒋世良[1] 吕滨[1] 韩磊[1] 宋会军[1] 张戈军[1] 金敬琳[1] 凌坚[1] 郑宏[1] 戴汝平[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心心血管疾病国家重点实验室阜外心血管病医院放射科,100037

出　　处：《中华放射学杂志》2012年第6期508-511,共4页Chinese Journal of Radiology

摘　　要：目的探讨MSCT在上腔静脉窦型房间隔缺损中的诊断价值。方法回顾性分析经MSCT诊断的20例上腔静脉窦型房间隔缺损患者的临床、X线胸片、经胸超声心动图等资料，及该病伴发畸形的MSCT解剖征象。结果患者的上腔静脉窦型房间隔缺损均位于房间隔后上方，直径9．134．1mm，平均（17．1±5．8）mm，均伴有右上叶肺静脉异常连接于上腔静脉。3例伴永存左上腔静脉，1例老年患者同时合并冠状动脉左前降支狭窄，另1例老年患者行右心导管检查提示重度肺动脉高压。6例行外科手术治疗，术中所见解剖异常与CT一致。结论对比剂增强MSCT横轴面图像结合VR三维重组可以明确显示上腔静脉窦型房间隔缺损及伴发畸形的解剖特征，对于该病的确诊及外科手术方案的制定具有较高的临床应用价值。Objective To evaluate the effectiveness of MSCT in the diagnosis of superior sinus venosus atrial septal defect. Methods The MSCT features of superior sinus venosus atrial septal defect in twenty cases were evaluated retrospectively. The following data were recorded： the size and location of sinus venosus atrial septal defect, the anatomy of pulmonary vein, including number of anomalously draining pulmonary veins and their site of drainage, and associated anomalies. Results In all patients, the superior sinus venosus atrial septal defect locates in the extraseptal wall, which normally separates the right upper pulmonary vein from superior vena cava （SVC）. And anomalous connection of right upper pulmonary venous and SVC was identified in all the patients. The mean value of the defect diameter was （ 17.1 ± 5.8） ram. Left superior vena cava was identified in 3 patients. In an elderly patient, left anterior descending branch of coronary artery presented significant stenosis. And in another elderly patient with large atrial septal defect, severe pulmonary hypertension was identified by cardiac catheterization. MSCT findings of superior sinus venosus atrial septal defect in 6 cases were finally confirmed by surgical operation. Conclusions Contrast- enhanced MSCT was a useful technique for the diagnosis of superior sinus venosus atrial septal defect, which accurately displayed the anatomical characteristics of the associated malformations for preoperative evaluation.

关 键 词：房间隔缺损 大血管错位 体层摄影术 螺旋计算机 

分 类 号：R816.2[医药卫生—放射医学] R541.1[医药卫生—临床医学]