先天性心脏病伴内脏异位患者应用CTA诊断的价值探究  

Value of CTA in the Diagnosis of Congenital Heart Disease with Heterotaxis

作　　者：高红[1] 杨瑞[1] 刘继伟[1] 冯小刚 GAO Hong;YANG Rui;LIU Ji-wei(Department of Imaging,Henan Thoracic Hospital,Zhengzhou 450000,Henan Province,China)

机构地区：[1]河南省胸科医院影像科,河南郑州450000

出　　处：《中国CT和MRI杂志》2018年第3期42-45,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨CT血管成像(CTA)在先天性心脏病(CHD)伴内脏异位患者中的临床诊断价值。方法回顾性分析2012年1月-2017年5月在我院接受治疗的64例CHD合并内脏异位患者的临床资料,入选前均经过手术及病理学证实,术前均行超声心动图、CTA检查。通过观察心室发育与异构类型、肺动脉和肺叶的发育、大动脉的位置关系、肝脏、胃腔在腹腔的位置及脾脏数目等确定CHD类型和内脏异位情况,并将CTA诊断结果与手术结果、心脏超声结果进行比较。结果以手术结果为标准,CHD类型方面,CTA、超声诊断准确率分别为90.63%(58/64)、76.56%(49/64),差异有统计学意义(P<0.05);内脏异位方面,CTA、超声诊断准确率分别为91.35%(61/64)、79.69%(51/64),差异有统计学意义(P<0.05);且CTA诊断内脏异位情况与手术结果相比差异无统计学意义(P>0.05)。结论 CTA可很好地显示心脏、大血管及胸腹腔内结构,对CHD伴内脏异位的临床诊断效果优于超声,对患者病情评估及手术方案制定有较高的应用价值。Objective To discuss the clinical value of CT angiography(CTA)in the diagnosis of congenital heart disease(CHD)with heterotaxis.Methods The clinical data of 64 patients with CHD complicated with heterotaxy treated in the hospital from January 2012 to May 2017 were analyzed retrospectively.The patients were selected after being confirmed by surgery and pathology,and they were examined with echocardiography and CTA.The type of CHD and the situation of heterotaxis were determined through observation of the ventricular development and heterogeneous type,the development of pulmonary artery and lung lobe,the aortic positional relationship,the locations of liver and gastral cavity in abdominal cavity and the number of spleen.The results of CTA were compared with those of surgery and echocardiography.Results With surgical results as the standard,the accurate rates of CTA and ultrasound in the diagnosis of the type of CHD were 90.63%(58/64)and 76.56%(49/64),respectively(P<0.05).The accurate rates of CTA and ultrasound in the diagnosis of heterotaxy were 91.35%(61/64)and 79.69%(51/64),respectively(P<0.05).There was no significant difference between CTA and surgery in the diagnosis of heterotaxy(P>0.05).Conclusion CTA can well display the structures of the heart,large vessels,thorax and abdomen.The clinical diagnosis of CHD and heterotaxy with CTA is superior to ultrasound.It is of great value in the evaluation of patient's condition and the development of the surgical plan.

关 键 词：先天性心脏病 内脏异位 CT血管成像 诊断 

分 类 号：R445[医药卫生—影像医学与核医学]