320排动态容积CT血管成像在婴幼儿冠状动脉瘘诊断中的应用  

Application of 320-slice Dynamic Volume CT Angiography in the Coronary Artery Fistulas in Infants and Young Children

作　　者：邹佳妮[1] 陈信坚[1] 罗金香[1] 陈友三[1] 陆然[1] 黄文才[1] 吴倩[1] 

机构地区：[1]广州军区武汉总医院放射科,湖北武汉437000

出　　处：《华南国防医学杂志》2016年第8期500-503,共4页Military Medical Journal of South China

摘　　要：目的探讨320排动态容积CT(320-slice dynamic volume CT,DVCT)血管成像在婴幼儿冠状动脉瘘(coronary artery fistula,CAF)诊断中的应用价值。方法回顾性分析8例诊断冠状动脉瘘患儿的临床和影像资料,年龄最小者61 d,最大者3岁,男3例,女5例。所有患儿均行低剂量前瞻性心电门控下DVCT血管成像,将获得的数据进行容积再现、多平面重建、最大密度投影,分析冠状动脉走行及心内外结构,计算有效辐射剂量,并与心脏彩超及手术结果对照。结果所有患儿的图像均为可诊断图像,左冠状动脉-右心室瘘2例,右冠状动脉-右心室瘘3例,左、右冠状动脉-右心室瘘1例(合并肺动脉闭锁,动脉导管未闭,左肺动脉发育不良),左冠状动脉-左心耳瘘1例(合并左冠状动脉走行变异),肺动脉主干-左心房瘘1例(合并主动脉骑跨,室间隔缺损,右位主动脉弓,左、右肺动脉起源于降主动脉)。平均辐射剂量约3.786 m Sv。结论低剂量DVCT血管成像可清晰显示婴幼儿冠状动脉瘘的起源、走行及瘘口情况,同时可明确诊断有无合并其他发育畸形,检查快速、无创、安全。Objective To investigate the application value of 320-slice dynamic volume CT（ DVCT） angiography in the coronary artery fistula（ CAF） diagnosis of infants and young child. Methods Eight patients diagnosed as coronary artery fistula were involved in the retrospective study,3 males and 5 females,aged from 61 days to 3 years old. All the patients were tested by using DVCT angiography under low-dose prospective transthoracic echocardiography. The DVCT results were analyzed,including maximum intensity projection（ MIP）,multiple planar reformation（ MPR）,and volume rendering（ VR）,the shape of coronary artery,the internal and external structure of heart,and compared with transthoracic echocardiography and operative findings. Otherwise,effective radiation doses were recorded. Results All DVCT results were diagnosed 2 cases with left coronary-right ventricle fistula,3 cases with right coronary-right ventricle fistula,1 case with left and right coronary- right ventricle fistula（ combined with pulmonary atresia,patent ductus arteriosus,left pulmonary hypoplasia）,1 case with left coronary-left auricle fistula（ combined with left coronary artery course variation）,and 1 case with pulmonary branch-left atrium fistula. The mean radiation dose was approximately 3. 786 m Sv. Conclusion Low-dose DVCT angiography can clearly show the origin,shape and state of CAF in infants and young children. It can be widely applied in clinical diagnosis because of rapid,safe and noninvasive.

关 键 词：320排动态容积CT 血管成像 婴幼儿 冠状动脉瘘 辐射剂量 

分 类 号：R540.4[医药卫生—心血管疾病]