320排CT心脏四维容积动态成像与TTE在先心病介入封堵术治疗中的比较研究  

A Comparative Study of 320-RoW CT Cardiac 4-Dimensional Volu metric Dynamic lmaging and.TTE in the.Treatment of|Interventional Occlusion of Precardiac Disease

作　　者：高海超[1] 李舒承[1] 王珠秀[1] GAO Hai-chao;LI Shu-cheng;WANG Zhu-xiu(Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei Province,China)

机构地区：[1]承德医学院附属医院,河北承德067000

出　　处：《中国CT和MRI杂志》2023年第4期82-84,共3页Chinese Journal of CT and MRI

基　　金：河北省医学科学研究课题计划(20211799)。

摘　　要：目的 比较研究先心病介入封堵术治疗中320排CT心脏四维容积动态成像(4D-CCTA)与经胸超声心动图(TTE)的应用价值。方法 选取2017年4月至2022年1月我院收治的93例房间隔缺损(ASD)患者,术前应用4D-CCTA、TTE对患者是否可进行介入封堵术进行筛选,确定ASD类型、部位、大小、左心室功能及是否合并其他畸形,术中在TTE引导下确定封堵器角度、位置及是否存在分流,并酌情对封堵器进行调整。应用Pearson分析4D-CCTA、TTE检测的ASD最大径、ASD最小径、房间隔总长、后上缘、后下缘、前上缘、前下缘及左心室功能之间的相关性。结果 术前4D-CCTA、TTE检测的ASD最大径、ASD最小径、房间隔总长、后上缘、后下缘、前上缘、前下缘比较,差异无统计学意义(P>0.05);4D-CCTA检测的ASD最大径(r=0.938)、ASD最小径(r=0.967)、房间隔总长(r=0.925)、后上缘(r=0.991)、后下缘(r=0.973)、前上缘(r=0.959)、前下缘(r=0.934)与TTE对应检测结果显著相关(P<0.001);术前4D-CCTA、TTE检测的LVEF、SV、ESV、EDV比较,差异无统计学意义(P>0.05);4D-CCTA检测的LVEF(r=0.976)、SV(r=0.982)、ESV(r=0.991)、EDV(r=0.975)与TTE对应检测结果显著相关(P<0.001);93例ASD患者,78例成功行介入封堵术,15例采用外科手术治疗;采用外科手术治疗的15例中,5例为下腔型ASD,TTE未能清晰显示下腔缘,7例上腔静脉窦型ASD伴心上型肺静脉异位引流,TTE仅提示为上腔型ASD,3例上腔静脉窦型ASD伴心内型肺静脉异位引流,因ASD缺损位置较高,TTE未显示肺静脉异位引流,而4D-CCTA对以上15例患者准确显示,并与术中所见相同。结论 4D-CCTA在评估ASD解剖学信息与左心室功能方面效果与TTE相似,可实现ASD及左心功能参数的一站式扫描,且能提高对ASD伴心脏大血管畸形或病变检出率,从而为ASD介入封堵术决策、封堵器选取等提供准确参考。Objective To compare the application value of 320-slice CT four-dimensional volume dynamic imaging(4D-CCTA)and transthoracic echocardiography(TTE)in the treatment of congenital heart disease with interventional closure.Methods A total of 93 patients with atrial septal defect(ASD)who were treated in our hospital from April 2017 to January 2022 were selected,and 4D-CCTA and TTE were used to screen the patients for interventional closure before surgery,and to determine the type and location of ASD.,size,left ventricular function and whether it is associated with other deformities,the angle,position and shunt of the occluder were determined under the guidance of TTE during the operation,and the occluder was adjusted as appropriate.Pearson was used to analyze the correlation between ASD maximum diameter,ASD minimum diameter,total length of atrial septum,posterior superior border,posterior inferior border,anterior superior border,anterior inferior border and left ventricular function detected by 4D-CCTA and TTE.Results There was no significant difference in the ASD maximum diameter,ASD minimum diameter,total length of atrial septum,posterior superior border,posterior inferior border,anterior superior border and anterior inferior border detected by 4D-CCTA and TTE before operation(P>0.05).4D-CCTA detected ASD maximum diameter(r=0.938),ASD minimum diameter(r=0.967),total length of atrial septum(r=0.925),posterior superior edge(r=0.991),posterior inferior edge(r=0.973),The anterior superior edge(r=0.959)and the anterior inferior edge(r=0.934)were significantly correlated with the corresponding test results of TTE(P<0.001);there was no difference in LVEF,SV,ESV and EDV detected by preoperative 4D-CCTA and TTE.Statistical significance(P>0.05);LVEF(r=0.976),SV(r=0.982),ESV(r=0.991),EDV(r=0.975)detected by 4D-CCTA were significantly correlated with the corresponding detection results of TTE(P<0.001);93 ASD patients,78 were successfully treated with interventional occlusion,and 15 were treated by surgery;among the 15 patients

关 键 词：4D-CCTA TTE 先心病 介入封堵术 

分 类 号：R541.1[医药卫生—心血管疾病]