电子束CT诊断婴幼儿先天性心脏病并与超声心动图及手术对照  

Electronic bean CT diagnosis of infant congenital heart disease with the comparison of echocardiogram and operation

作　　者：李向民[1] 周旭辉[1] 杨有优[1] 孟悛非[1] 彭谦[1] 谭智育[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080

出　　处：《中华放射学杂志》2003年第7期644-647,共4页Chinese Journal of Radiology

摘　　要：目的　与超声心动图及手术对照 ,探讨电子束CT(EBCT)在婴幼儿先天性心脏病 (简称先心病 )诊断中的价值。方法　对 80例临床怀疑或诊断为先心病的婴幼儿行EBCT心脏单层增强扫描及电影序列扫描 ,将结果与超声心动图 (TTE)及手术结果作对照。其中 39例经手术确诊。结果全组共 16种先心病 ,发绀类 5 3例 ,非发绀类 2 7例。 39例手术证实的先心病共 10 1处畸形 ,其中EBCT诊断准确率 96 % (97/ 10 1) ,TTE诊断准确率 87% (88/ 10 1)。 80例患儿EBCT共发现畸形 2 0 6处 ,TTE发现 15 9处。EBCT与TTE诊断的准确率差异有非常显著性意义 (χ2 =6 .2 31,P <0 .0 1)。结论EBCT可以清晰客观地显示先心病病理解剖形态 ,特别对复杂畸形的节段分析有重要价值。与TTE相比 ,EBCT在反映主动脉病变、肺动脉发育情况及肺静脉异位引流等方面较TTE直观和优越。Objective To explore the advantage and limitation in the diagnosis of infant congenital heart disease (CHD) by electron beam computed tomography (EBCT). Methods Eighty patients suspected or diagnosed as infant CHD underwent dynamic contrast enhanced EBCT imaging. EBCT imaging was carried out in two steps: single slice mode scanning and multiple slice mode scanning. The EBCT results of 80 cases were correlated with echocardiogram and operation records. 39 cases were confirmed by surgery. Chi-Square test was used for statistical analysis. Results Among 80 patients, there were 27 cases in non-cyanosis and 53 cases in cyanosis. In this group including 16 types of CHD, 206 malformations were revealed with EBCT while 159 abnormalities with echocardiogram. 101 lesions were proved by surgery, which demonstrated a diagnosis accuracy of 96% (97/101) with EBCT, and 87% (88/101) with echocardiogram. A statistical significant difference was observed between the two methods (χ 2=6.231, P <0.01). Conclusion EBCT scanning can demonstrate the pathological morphology of CHD, especially, EBCT is helpful in the sequential segmental analysis in complex CHD. It is better than echocardiogram in demonstrating the aortic congenital disease and pulmonary artery development and anomalous pulmonary venous drainage.

关 键 词：婴幼儿 先天性心脏病 电子束CT诊断 超声心动图 手术治疗 

分 类 号：R445[医药卫生—影像医学与核医学] R726.5[医药卫生—诊断学]