双源CT血管造影在先天性主动脉缩窄诊断中的应用价值  

Value of dual-source CT angiography in the diagnosis of congenital aortic coarctation

作　　者：王承胜[1] 段青[1] 薛蕴菁[1] 黄新明[1] 王莉莉[1] 王华[1] 

机构地区：[1]福建医科大学附属协和医院放射科,福州350001

出　　处：《天津医科大学学报》2017年第3期231-234,共4页Journal of Tianjin Medical University

摘　　要：目的:探讨双源CT血管造影(DSCTA)诊断先天性主动脉缩窄的应用价值。方法:回顾性分析临床拟诊并经手术证实的32例主动脉缩窄患者的影像学资料。所有患者术前同时行彩色多普勒超声心动图(CDE)和DSCTA。根据双源CT图像确定是否存在主动脉病变以及伴随的心血管畸形,并与超声心动图及手术结果对照分析。结果:32例患者的主动脉缩窄术前DSCTA均获得正确诊断。28例为局限性缩窄,4例形成弥漫性长管状缩窄。DSCTA诊断主动脉缩窄的敏感性为100%(32/32),而CDE为84.38%(27/32)。5例为单纯型主动脉缩窄,27例为伴有其它心血管畸形的复杂型主动脉缩窄。在复杂型主动脉缩窄中,DSCTA诊断19例合并室间隔缺损,1例漏诊。DSCTA诊断的准确性为95%(19/20),而CDE为100%(20/20)。其余畸形DSCTA和CDE均诊断正确。结论:双源CT血管造影能准确地对主动脉缩窄进行诊断,并能同时显示合并胸部的大血管及心脏畸形。Objective： To investigate the value of dual-source CT angiography（DSCTA） in the diagnosis of congenital aortic coarctation.Methods： The image data of 32 patients with coarctation of aorta confirmed by surgery were analyzed retrospectively. All patients underwent both color doppler echocardiography（CDE） and DSCTA before operation. According to dual-source CT images,the presence of aortic lesions were determined and found to be associated with cardiovascular abnormalities, which were compared with CDE and surgical results. Results： All 32 patients with coarctation of aorta were diagnosed accurately on preoperative DSCTA. Twenty-eight cases were localized of coarctation, and 4 cases were diffuse long tubular coarctation. The sensitivity of DSCTA was 100%（32/32） for coarctation of aorta, while for CDE, the sensitivity was 84.38%（27/32）. Five cases were simple coarctation of aorta, and 27 cases were complex coarctation of aorta which was accompanied with other cardiovascular malformations. In patients with complex coarctation of aorta, 19 cases with ventricular septal defect were diagnosed by DSCTA, and 1 case missed the diagnosis. The accuracy on DSCTA was 95%（19/20）, while CDE was 100%（20/20）. The rest of the malformations were diagnosed acccurately on both DSCTA and CDE. Conclusion： DSCT angiography can make accurate diagnosis in patients with coarctation of aorta, and can also show accompanyed thoracic great vessels and cardiac malformations.

关 键 词：体层摄影术 X线计算机 主动脉缩窄 血管造影术 

分 类 号：R814.43[医药卫生—影像医学与核医学]