CT容积螺旋穿梭技术评估儿童先天性心脏病血液分流位置及方向的研究  

Volume helical shuttle CT scanning technique for evaluating the location and direction of shunt in congenital heart disease of children

作　　者：曹永丽[1] 彭芸[1] 王帆宁[1] 刘勇[1] 

机构地区：[1]首都医科大学附属北京儿童医院影像中心,北京100045

出　　处：《放射学实践》2013年第7期715-718,共4页Radiologic Practice

基　　金：首都医学发展基金(2009-2077);北京市卫生系统高层次卫生技术人才培养项目(2011-3-054);科技重大专项项目(课题)(2011ZX09302-007-01)

摘　　要：目的:探讨CT容积螺旋穿梭(VHS)技术对儿童先天性心脏病血液分流位置及方向的评估价值。方法:32例先天性心脏病患儿(男24例,女8例,年龄1～24个月,中位年龄3个月),采用64排CT-VHS技术进行心血管检查,观察和分析心血管畸形的类型和程度,同时记录血液分流的方向和位置,并将CT诊断结果与超声心动图检查结果进行比较。结果:超声心动图检查共发现26例患儿存在44处分流。CT-VHS技术共发现24例患儿存在30处分流,包括24处心内分流和6处大血管间分流。分流表现包括单纯左向右分流20例患儿共22处分流,其中室间隔缺损8例、房间隔缺损10例、动脉导管未闭2例、主-肺动脉间隔缺损2例;单纯右向左分流6例共6处分流,包括室间隔缺损4例、动脉导管未闭2例;双向分流见于2例房间隔缺损的患儿。以超声心动图检查结果作为金标准,CT VHS技术检出分流的敏感度、特异度及符合率分别为60.9%(28/46)、75.0%(6/8)和63.0%(34/54)。结论:CT-VHS技术对小儿先心病的诊断准确性高,除了能显示解剖形态学异常,还能作为一种非侵入性检查方法准确客观地显示有无分流及分流的位置和方向,对血流动力学改变具有一定的诊断价值。Objective：To demonstrate the value of volume helical shuttle （VHS） CT scanning technique in the evalua-tion of the location and direction of shunt in congenital heart disease of children. Methods：32 children （24 boys and 8 girls） having congenital heart disease with the age ranged from 1-24m （mean 3m） were recruited. 64-slice CT with VHS tech-nique was used to study the pattern and degree of cardiovascular deformity,and the location and direction of shunt were re-corded simultaneously. The CT findings were compared with those of echocardiogram retrospectively. Results：44 shunts in 26 patients were identified on echocardiogram. 30 shunts in 24 patients were assessed on CT with VHS technique,including 24 intra-cardiac shunts and 6 inter-arterial shunts. The patterns of shunt showed as simple left-to-right shunt in 20 children （22 shunts） including ventricular septal defect （n： 8）, atrial septal defect （n= 10）, patent duetus arteriosus （ n = 2）, aorti-eopulmonary septal defect （n= 2） ;simple right-to-left shunt in 6 children （6 shunts） including ventricular septal defect （n= 4）, patent ductus arteriosus （n= 2） ;and bilateral shunt in 2 patients with atrial septal defect （n= 2）. Using echocardiogram as the gold standard,the sensitivity, specificity and accuracy of CT with VHS technique in identifying shunt flow was 60. 9% （28/46）,75.0% （6/8） and 63.0% （34/54）,respectively. Conclusion：Dynamic CT with VHS technique could be used in the diagnosis of congenital heart diseases in children. Apart from displaying anatomic deformities, it is a non-invasive technique to objectively demonstrate the presence, the location and direction of shunt, and plays a helpful role in the evalua-tion of hemodynamic changes.

关 键 词：体层摄影术 X线计算机 容积螺旋穿梭技术 先天性心脏病 血流动力学 

分 类 号：R816.92[医药卫生—放射医学]