MSCT低剂量血管成像技术在儿童先天性主动脉畸形诊断中的应用  

Application of Low-dose Multi-slice Spiral CT Angiography in Children with Congenital Anomalies of Aorta

作　　者：杨旭峰[1] 王霁籫 彭振鹏[1] 周旭辉[1] 李向民[1] 

机构地区：[1]中山大学附属第一医院放射科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2015年第6期925-931,共7页Journal of Sun Yat-Sen University:Medical Sciences

摘　　要：【目的】探讨多层螺旋CT（MSCT）低剂量血管成像技术在儿童先天性主动脉畸形诊断中的应用价值。【方法】对84例采用64层螺旋CT低剂量血管成像技术诊断的儿童先天性主动脉畸形病例作回顾性分析,并与超声心动图（TTE）及手术、心血管造影结果进行比较分析,其中63例经手术确诊、21例经心血管造影证实。术后CT复查26例。【结果】根据患儿体质量分别采取80、100及120 k V管电压,其例数分别为32、38及14,管电流自动调节（在35~80 m A范围变动）,X线辐射剂量（m Gy）比预设常规扫描模式减低幅度为20%~50%不等。所有病例图像均达到诊断标准。全组84例中,包括双主动脉弓3例、主动脉弓褶曲10例、主动脉缩窄18例、主动脉弓离断7例、单纯动脉导管未闭41例、共同动脉干3例及主-肺动脉窗2例,其中CT诊断准确率97.6%（82/84）,TTE诊断准确率83.3%（70/84）。84例中,合并其他畸形共37处,其中CT发现32处,TTE发现33处。术后CT复查中,发现术后并发症7例。【结论】64层螺旋CT低剂量血管成像能有效降低辐射剂量的同时,可以清晰客观地显示儿童主动脉畸形及其合并畸形的病理解剖,与超声心动图互补,能明显提高主动脉畸形的检出率及诊断准确率,对主动脉畸形的术前诊断及术后疗效观察有重要价值,可基本代替血管造影检查。【Objective】 To investigate the applications of low-dose multi-slice spiral CT（MSCT） angiography in children with congenital anomalies of the aorta. 【Methods】 84 cases of children with congenital anomalies of the aorta who underwent low-dose 64-slice spiral CT angiography were retrospectively analyzed, in which 63 cases confirmed by surgery, 21 cases confirmed by angiography. CT findings were clinically correlated with results of transthoracic echocardiography（TTE）, angiography, or surgery.Postoperative CT scans were undergone in 26 cases. 【Results】 We used tube voltage settings with 80, 100, and 120 k V in 32, 38 and 14 cases respectively based on the weight. The tube current is automatically adjusted（ranged from 35 m A to 80 m A）. X-ray radiation dose（m Gy） was significantly reduced by 20% to 50% than the preset conventional scan mode. CT image qualities of all cases met the diagnostic requirements. Among the whole group of 84 cases, included double aortic arch in 3 cases, aortic arch fold in10 cases, aortic coarctation in 18 cases, interrupted aortic arch in 7 cases, simple patent ductus arteriosus in 41 cases, truncus arteriosus in 3 cases and aortopulmonary window in 2 cases, with CT diagnostic accuracy 97.6%（82 / 84） and TTE diagnostic accuracy 83.3%（70 / 84）. In all 84 cases, a total of 37 combined malformations were detected, which found 34 combined malformations by CT and 33 by TTE. Postoperative complications were found in 7 cases through postoperative CT scans. 【Conclusion】Low-dose 64-slice CT angiography can effectually reduce radiation exposure, while it can clearly and objectively show pathologic anatomy of aortic abnormalities and combined malformations in children. Complementary to echocardiography, low-dose 64-slice CT angiography can significantly improve the detection of aortic abnormalities and diagnostic accuracy. It plays a critical role in preoperative diagnosis and evluation of postoperative therapeutic effect. It can basically replace invasive angiog

关 键 词：心血管疾病 先天性 体层摄影术 X线计算机 

分 类 号：R814[医药卫生—影像医学与核医学]