64层螺旋CT血管造影在婴幼儿法洛四联症诊断中的价值  

The Value of 64-Slice Spiral CT Angiography in the Diagnosis of Tetralogy of Fallot in Infants

作　　者：梁超逸 李庚武 王昶 LIANG Chao-yi;LI Geng-wu;WANG Chang(Image Center,Children's Clinical College of Anhui Medical University(Anhui Provincial Children's Hospital),Hefei 230051,Anhui Province,China)

机构地区：[1]安徽医科大学附属省儿童医院(安徽省儿童医院)影像中心,安徽合肥230051

出　　处：《中国CT和MRI杂志》2022年第4期69-71,165,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨64层多排螺旋CT血管造影技术(CTA)在婴幼儿法洛四联症(TOF)及伴发畸形诊断中的价值。方法选取2016年1月至2019年1月临床诊断TOF的58例患儿,行64层多排螺旋CT血管造影检查,并用多平面重建(MPR)、容积成像(VR)、最大密度投影(MIP)进行图像重组。同时行超声心动图(UCG)检查,以手术结果为“金标准”,比较两种检查方法在TOF患儿心血管畸形中的诊断准确率。结果58例TOF患儿中53例为典型TOF,5例为不典型TOF。经手术确诊心内畸形186处,CTA检查出184处,诊断准确率为98.92%,UCG检查出181处,诊断准确率97.3%,两种检查方法对心内畸形的诊断准确率无统计学意义(P>0.05);手术确诊心外畸形67处,CTA检查漏诊1处,超声心动图漏诊30处,误诊2处,CTA对心外大血管畸形的诊断符合率为98.51%,明显高于UCG(55.22%),二者差异有统计学意义(P<0.01)。结论64层多排螺旋CT血管造影技术能准确清晰地显示TOF的解剖形态以及为术前评估提供重要依据。Objective To explore the diagnostic value of 64-slice multi-slice spiral CT angiography(CTA)in tetralogy of Fallot(TOF)and its associated malformations in infants.Methods Fifty-eight children with TOF diagnosed clinically from January 2016 to January 2019 were selected for 64-slice multi-slice spiral CT angiography.Multiplanar reconstruction(MPR),volume imaging(VR)and maximum intensity projection(MIP)were used for image reconstruction.At the same time,echocardiography(UCG)was performed to compare the accuracy of the two methods in the diagnosis of cardiovascular malformations in children with TOF.Results Among 58 cases of TOF,53 cases were typical TOF and 5 cases were atypical TOF.Among 186 intracardiac malformations confirmed by operation,184 were detected by CTA,the diagnostic accuracy rate was 98.92%,181 by UCG,the diagnostic accuracy rate was 97.3%.There was no significant difference between the two methods in the diagnostic accuracy of intracardiac malformations(P>0.05).The diagnostic accuracy of CTA for extracardiac malformations was 98.51%,which was significantly higher than that of UCG(55.22%).There were significant statistical differences between CTA and UCG(P<0.01).Conclusion 64-slice multi-slice spiral CT angiography can accurately and clearly display the anatomy of TOF and provide important basis for preoperative evaluation.

关 键 词：先天性心脏病 法洛四联症 CT血管造影 体层摄影术 X线计算机 超声心动图 

分 类 号：R725.4[医药卫生—儿科] R445.3[医药卫生—临床医学]