室间隔偏曲的婴儿法洛四联症外科根治术前的左心室大小评价方法

目的:本研究旨在对比64排CT和二维经超声心动图,对外科手术治疗室间隔偏曲的婴儿法洛四联症前的左心室评价的准确性。方法:2012年12月至2013年11月期间,接受法洛四联症根治手术的50例婴儿中的12例,(其中男婴7例,女婴5例,月龄6~12个月,体质量7~9.9kg),12例患儿术前均接受了标准的二维经胸超声心动图和64排CT检查,超声心动图均发现室间隔偏曲同时测量左心室舒张末期内径,64排CT定量左心室容积。所有的12例患儿均接受了法洛四联症的根治术,术后效果良好。结果:二维经胸超声心动图测量左心室舒张末期内径均明显低于同龄患儿的平均水平,64排CT用来定量左心室容积容积指数均30mL/m2。二维经胸超声心动图的测量较64排CT明显低估了左心室的发育情况。最后12例患儿均行根治术,未行分期手术,术后均没有低心排排出量综合征(低心排)的表现,12例患儿均没有死亡,恢复良好。结论:64排CT较二维经胸超声心动图能够更准确地评价室间隔偏曲的法洛四联症婴儿的左心室大小,以利外科手术的选择。

Assessment of left ventricle size following operations in tetralogy of Fallot with septal deviation

Objective ：This study was designed to compare the accuracy of 64-row contrast computed tomography（CT） and 2-dimensional transthoracic echocardiography of left ventricle of infants with tetralogy of Fallot before surgery. Methods： From December,2012, to September, 2013, A total of 12 infants with tetralogy of Fallot（7 male and 5 female, with age of 6-12 months, weight 7-9. 9kg） in 50 infants,who were undertook complete repair in our hospital, of which prospectively received 64-row contrast CT, 2D transthoraeic Echo （ as the reference standard） before the operations. Septal deviation were detected by echoeardiography in 12 infants. End-Diastolic internal dimensions of left ventricle measured by echo and end-diastolic volume of left ventricle measured by 64-row contrast CT, all of the 12 patients received correction surgery and recovered well. Results： The end-diastolic dimensions of the left ventricle were very small ,which were much lower than the average level of the same age, but at the same time, the end-diastolic volume of the left ventricle index were higher than 30mL/m2, where as 2D transthoraeic Echo significantly underestimated the left ventricle compared with 64-row contrast CT. The correction surgery were done in the 12 infants, no staged operations were done or low cardiac output occurred post surgery, and no death. All of infants recovered well. Conclusion： 64-row contrast CT may be more accurate than 2D transthoracic Echo for assessment of the left ventricle for the surgical indications for the infants with tetralogy of Fallot with septal deviation.