64层螺旋CT诊断复杂先天性心脏病的临床价值

目的 探讨64层螺旋CT(64SCT)对比增强及后处理技术对复杂先天性心脏病(CCHD)的诊断价值.方法 39例CCHD手术前均行经胸心脏二维超声(TTE)检查和648CT对比增强扫描检查,其中CT扫描时有8例采用心电门控技术.手术后按心内畸形、心脏大血管连接部畸形及大血管部分畸形分别统计CT及TTE 2种检查方法及有否使用心电门控技术的诊断正确率,并使用SPSS13.0版软件包对结果行χ~2检验.结果 手术证实畸形共102处,其中心脏部分畸形47处,CT和TTE的诊断准确率分别为85.1%和95.7%,2种检查的诊断正确性差异无显著性意义(χ~2=2.68,P>0.05);心脏大血管连接部分及大血管部分畸形共计55处,CT和TTE的诊断准确率分别为98.2%和78.2%,64SCT诊断正确率明显高于TTE(χ~2=14.64,P<0.01).未使用和使用心电门控在定性诊断准确性差异上无显著意义(χ~2=1.84,P>0.05),但采用心电门控技术CT扫描图像更清晰.结论 64CT对CCHD的检查具有较高的诊断价值.扫描时是否采用心电门控技术对CCHD的定性诊断无明显统计学差别.

Clinical Value of 64-slice Computed Tomography in the Diagnosis of Complex Congenital Heart Disease

Objective To study the clinical value of 64-slice spiral computed tomography(64SCT) contrast-enhanced scan and three-dimensional reconstructed techniques in the diagnosis of complex congenital heart disease(CCHD). Methods 39 patients with CCHD underwent CT angiography and transthoracic echocardiograms (TTE). Of them, the electrocardiographic-gating technique was used in 8 cases. The accurate rates in diagnosing CCHD with CT, TTE and CT with or without electrocardiographic-gating were analysed compared with that of operation and χ~2 test using SPSS13.0 tool. Results A total of 102 cardiac deformities con-firmed by operations,those included 47 intracardiac deformities,the diagnostic accuracys with CT and TTE were 85.1% and 95.7%, respectively, and there was no obvious difference among them (χ~2=2.68, P>0.05). 55 extracardiac deformities, the definite diagnos-tic rates with CT and TTE were 98.2% and 78.2%, respectively. CT was superior to TTE in the indentification of extracardiac de-formities(χ~2= 14.64 ,P<0.01). There was no obvious difference between with and without electrocardiographic-gating technique during CT scanning in diagnosis of cardiac deformities(χ~2=1.84, P>0.05). Conclusion 64SCT has significant value in diagnosis of CCHD,and there was no obvious difference in diagnosis of cardiac deformities by 64SCT between with and without electrocardio-graphic-gating technic.