双源CT与TTE诊断CCHD的应用价值对比  

Comparison of Application Value of DSCT and TTE in the Diagnosis of CCHD

作　　者：王宁 张凯悦 胡安宝 孙伟 王瑜 杨舒 WANG Ning;ZHANG Kai-yue;HU An-bao(Department of Ultrasound,Zaozhuang Mining Group Central Hospital, Zaozhuang 277000, Shandong Provence,China)

机构地区：[1]枣庄矿业集团中心医院超声科,山东枣庄277000 [2]枣庄矿业集团中心医院CT室,山东枣庄277000 [3]枣庄矿业集团中心医院磁共振室,山东枣庄277000

出　　处：《中国CT和MRI杂志》2019年第7期46-49,共4页Chinese Journal of CT and MRI

摘　　要：目的研究双源CT(DSCT)与经胸超声心动图(TTE)对复杂先天性心脏病(CCHD)的诊断价值及临床应用效果。方法回顾性分析2016年6月至2018年6月我院109例CCHD患者临床资料,以手术结果为金标准,分析DSCT和TTE对CCHD患者检查结果及两种检查方法对心脏畸形、大血管畸形和全部畸形诊断准确率。结果 109例CCHD患者经手术证实共存在畸形241处,其中心脏畸形115处,占比47.72%;大血管畸形126处,占比52.28%;DSCT和TTE对心脏畸形检查准确率分别为86.96%和94.78%(P<0.05),DSCT漏诊、误诊15处,其中房间隔缺损4处、室间隔缺损3处、主动脉瓣狭窄伴关闭不全2处、肺动脉瓣狭窄2处、心室反位2处、单心房1例、二尖瓣闭锁1例;TTE漏诊误诊6例,分别为室间隔缺损2例、房间隔缺损1例、单心房1例以及单心室1例,DSCT和TTE对大血管畸形检查准确率分别为92.86%和72.22%(P<0.05),DSCT漏诊、误诊9例,其中动脉导管未闭3例、肺动脉口狭窄2例、肺静脉异位引流2例、永存左上腔1例以及大动脉转位1例;TTE误诊、漏诊35例,其中主动脉骑跨6例、动脉导管未闭5例、大动脉转位5例、肺动脉口狭窄4例、永存左上腔4例、肺静脉异位引流3例、主动脉弓缩窄3例、主肺动脉侧枝形成3例、肺动脉闭锁2例,两种检查方法对CCHD检查准确率分别为90.04%和82.99%(P<0.05)。结论 DSCT检查对心脏畸形诊断准确率不及TTE,对大血管畸形诊断准确率优于TTE,联合应用两种检查可有效提升CCHD诊断准确性和安全性。Objective To study the diagnostic value and clinical application effects of dualsource computed tomography(DSCT) and transthoracic echocardiography(TTE) for complex congenital heart disease(CCHD). Methods The clinical data of 109 patients with CCHD in our hospital from June 2016 to June 2018 were retrospectively analyzed.The surgical results were used as the gold standard to analyze the examination results of DSCT and TTE in CCHD patients and the diagnostic accuracy rates of two examination methods in the diagnosis of cardiac malformation, macrovascular malformation and all malformation. Results A total of 241 malformations were confirmed by surgery in 109 CCHD patients, including 115 cardiac malformations(47.72%) and 126 macrovascular malformations(52.28%). The accuracy rates of DSCT and TTE were 86.96% and 94.78%for cardiac malformation(P<0.05), and there were 15 missed diagnosis and misdiagnosis by DSCT, including 4 atrial septal defect, 3 ventricular septal defect, 2 aortic stenosis with regurgitation, 2 pulmonary valve stenosis, 2 ventricular reversal, 1 single atrium and 1 mitral atresia. There 6 misdiagnosis and missed diagnosis by TTE, including 2 ventricular septal defect, 1 atrial septal defect, 1 single atrium and 1 single ventricle. The accuracy rates of DSCT and TTE were 92.86% and 72.22% for macrovascular malformation(P<0.05),and there were 10 missed diagnosis and misdiagnosis by DSCT, including 3 patent ductus arteriosus, 2 pulmonary orifice stenosis, 2 pulmonary venous anomalous drainage,1 permanent left upper chamber and 1 transposition of great artery. There were 35 misdiagnosis and missed diagnosis by TTE, including 6 aortic overriding, 5 patent ductus arteriosus, 5 transposition of great arteries, 4 pulmonary orifice stenosis, 4 permanent upper left ventricle, 3 pulmonary venous anomalous drainage, 3 transverse aortic constriction,3 main pulmonary artery collateral formation and 2 pulmonary atresia. And the accuracy rates of two methods for CCHD were 90.04% and 82.99%(P<0.05). Conclusion The a

关 键 词：复杂先天性心脏病 双源CT 经胸超声心动图 

分 类 号：R540.45[医药卫生—心血管疾病]