双源CT大螺距技术在婴幼儿完全性肺静脉异位引流诊断中的应用  

Clinical application of high-pitch dual-CT in total anomalous pulmonary venous connections in children

作　　者：刘永顺 赵月霞 程召平[3] 乌大尉[3] 段艳华[3] 晁宝婷[3] 王锡明[3] 

机构地区：[1]山东省烟台市牟平区整骨医院放射科,山东烟台264100 [2]山东省定陶县人民医院放射科,山东定陶274000 [3]山东大学附属山东省医学影像学研究所山东省心脑血管疾病诊治重点实验室,山东济南250021

出　　处：《医学影像学杂志》2015年第9期1575-1578,共4页Journal of Medical Imaging

基　　金：中国博士后科学基金(2014M550658);山东省优秀中青年科学家科研奖励基金计划(BS2013YY060);山东省医药卫生科技发展计划(2013WS0180)

摘　　要：目的 探讨双源CT（dual-source CT,DSCT）低剂量大螺距技术在婴幼儿完全性肺静脉异位引流（total anomalous pulmonary venous connection,TAPVC）诊断中的应用价值。方法 回顾性分析我院10例TAPVC婴幼儿患者的临床资料,所有患儿术前行前瞻性心电门控下DSCT大螺距血管成像,均经手术治疗证实。由两位放射科医师按4分法对CT图像质量进行主观评价,同时记录辐射剂量。定量数据表示为平均数±标准差,分类数据表示为比例和百分比。观察者之间图像质量主观评分的一致性通过使用Kappa检验进行评估。结果 所有患儿的CT图像均为可诊断图像,主观评分为2.7±0.7（2~4分）,两位医师的评价一致性好（k=0.79）。10例TAPVC诊断及分型均和手术结果一致,包括心上型6例、心内型2例、心下型2例。平均剂量长度乘积及有效辐射剂量分别为（10.8±4.3）mGy·cm和（0.26±0.08）mSv。结论 DSCT低剂量大螺距技术是一种可靠的诊断婴幼儿TAPVC的检查方法,能为术前提供很好的参考依据。Objective To explore the usefulness of high-pitch dual-source CT（DSCT） angiography in the evaluation of total anomalous pulmonary venous connections. Methods Ten patients （mean age： 0. 31±0. 27 yrs, age range： 1~8 months, boy： 6） with total anomalous pulmonary venous connections underwent DSCT angiography. The types of total a- nomalous pulmonary venous connections and the number of pulmonary veins were confirmed by the surgical findings. The subjective image quality was evaluated on a four-point scale by two radiologists. Radiation dose values were calculated. Quantitative data were expressed as means±standard deviations and categorical data were given in proportions and per- centages. Interobserver agreement in subjective image quality grading was assessed by using kappa statistics. Results All images were diagnosable. The average subjective image quality score was 2.7±0.7（2~4）. Two radiologists made good a- greement （ k =0.79）. In all patients, CT angiography correctly depicted total anomalous pulmonary venous connections. Six cases were the supracardiac type, two cases were the cardiac type,, and two cases were the mixed type. The mean dose-length product was （10.8±4.3） mGy · cm resulting in an estimated mean effective radiation dose of （0.26±0.08） mSv. Conclusion DSCT angiography provides high diagnostic accuracy for the preoperative assessment of total anomalous pulmonary venous connections in children.

关 键 词：完全性肺静脉异位引流 双源CT 大螺距 辐射剂量 

分 类 号：R543.2[医药卫生—心血管疾病] R814.42[医药卫生—内科学]