心电门控主动脉计算机断层扫描血管造影在主动脉窦瘤诊断中的应用  

Application of ECG-gated aortic computed tomography angiography in the diagnosis of aortic sinus aneurysm

作　　者：杨林[1] 梁长虹[1] 黄美萍[1] 刘辉[1] 

机构地区：[1]广东省人民医院(广东省医学科学院)放射科,广州510080

出　　处：《岭南心血管病杂志》2014年第6期748-751,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨心电门控主动脉计算机断层扫描血管造影(computed tomography angiography,CTA)在主动脉窦瘤诊断中的应用价值。方法回顾性分析23例经手术证实的主动脉窦瘤患者的CTA图像,所有CTA图像均在心电门控条件下完成扫描。评估CTA图像上病灶的起源及大小、主动脉瘤是否破裂、冠状动脉位置及相关心血管发育异常的显示情况。结果 23例主动脉瘤患者中,感染性心内膜炎(获得性)6例(6/23,26.1%),先天性17例(17/23,73.9%)。其中起源于右冠状动脉窦12例(52.2%),左冠状动脉窦7例(30.4%),无冠状动脉窦4例(17.4%),CTA图像与手术吻合23例(100%)。窦瘤压迫右心室6例(26.1%),右心室流出道3例(13.0%),右心房4例(17.4%),左心室6例(26.1%),左心房4例(17.4%),CTA图像与手术吻合23例(100%)。窦瘤破裂11例(47.8%),未破12例(52.2%),CTA图像与手术吻合22例(95.7%)。合并心血管畸形:主动脉二叶瓣5例(21.7%),室间隔缺损3例(13.0%),主动脉缩窄4例(17.4%),主动脉弓褶曲2例(8.7%)。除1例瘘口、1例室间隔缺损CTA漏诊外,其余所见均与手术所见吻合。结论心电门控主动脉CTA是诊断主动脉窦瘤及其并发症的有效方法,可提供准确的细节丰富的图像帮助诊断。Objectives To investigate the value of ECG-gated aortic computed tomography angiography （CTA） in the diagnosis of aortic sinus aneurysm.Methods Totally 23 patients with aortic sinus aneurysm receiving ECG-gated aortic CTA were enrolled in this study.All the cases were confirmed by operation.Assessment variables of CTA images included site and size of lesion,rupture of aortic sinus aneurysm,cardiovascular malformation and situation of coronary artery.Results Of the 23 cases with aortic sinus aneurysm,6 cases （26.1％） were confirmed infective endocarditis,and 17 （73.9％） were congenital heart disease.The aneurysms originated from right-,left-and non-coronary sinus in 12 cases （52.2％）,7 cases （30.4％） and 4 cases （17.4％） respectively.CTA images 100％ matched those observed by operation.Six cases （26.1％） were with right ventricle compression,3 cases （13.0％） with right ventricular outflow tract,4 cases （17.4％） with right atrium,6 cases （26.1％） with left ventricle,4 cases （17.4％） with left atrium.CTA images 100％ matched those observed by operation.Of these patients,11 sinus aneurysms （47.8％） were ruptured and 12 （52.2％） were not.CTA images 95.7％ matched those observed by operation.Five cases （21.7％） complicated with bicuspid aortic valve,3 cases （13.0％） with ventricular spetal defect （VSD）,4 cases （17.4％） with aortic coarctation,2 cases （8.7％） with aortic arch abnormality.One case with VSD and 1 case with ruptured aortic sinus were missed-diagnosed by CTA images.Conclusions ECG-gated aortic CTA is useful in the diagnosis of aortic sinus aneurysm,which can provide exact location and more details for diagnosis.

关 键 词：主动脉窦瘤 心电门控 计算机断层扫描血管造影 

分 类 号：R543.16[医药卫生—心血管疾病]