心脏超声结合CTA在复杂先天性心脏病诊断中的应用

目的研究心脏超声结合CT血管造影(CTA)在复杂先天性心脏病(CCHD)中的诊断价值。方法回顾性分析医院2017.01~2019.01间收治的94例疑似CCHD患儿影像学资料,比较心脏超声联合CTA在诊断CCHD中的应用效果。结果94例患儿均行手术治疗,术中确诊10种疾病类型,心脏超声、CTA、心脏超声结合CTA诊断准确率分别为85.11%、92.55%、96.81%;术中共发现先天性心脏内结构异常13种,共计42处,心脏超声、CTA及心脏超声结合CTA在诊断患者心内结构异常中的诊断率无显著性差异(P>0.05);术中发现21种先天性心外大血管畸形,共计54处,CTA及心脏超声结合CTA在诊断心外大血管畸形中的准确率显著高于心脏超声,三者诊断正确率差异显著(P<0.05)。结论单纯的CTA在诊断CCHD中的价值高于心脏超声,但超声依旧是临床应用范围最广泛、实用价值最高的检查方式,而超声联合CTA则可有效提高CCHD诊断价值,建议临床将CTA作为心脏超声的后续检查方式,以提高CCHD诊断效果。

Application of Cardiac Ultrasound Combined with CTA in the Diagnosis of Complex Congenital Heart Disease

Objective To study the diagnostic value of cardiac ultrasound combined with CT angiography(CTA)in complex congenital heart disease(CCHD).Methods The imaging data of 94 children patients with suspected CCHD admitted from January 2017 to January 2019 were retrospectively analyzed.The application effects of cardiac ultrasound combined with CTA were compared in the diagnosis of CCHD.Results All the 94 children patients underwent surgical treatment,and ten types of disease were diagnosed intraoperatively.The diagnostic accuracy of cardiac ultrasound,CTA and cardiac ultrasound combined with CTA were 85.11%、92.55%、96.81%,respectively.There were 13 types of congenital intracardiac structural abnormalities during operation,42 sites in total.There was no significant difference in the diagnostic rate of cardiac ultrasound,CTA and cardiac ultrasound and CTA in the diagnosis of intracardiac structural abnormalities(P>0.05).21 kinds of congenital extracardiac macrovascular malformations were found during operation,54 sites in total,and the accuracy rate of CTA and cardiac ultrasound and CTA were significant higher than that of cardiac ultrasound in the diagnosis of extracardiac macrovascular malformations,and there was a significant difference in the diagnostic accuracy rate among them(P<0.05).Conclusion The value of simple CTA is higher than that of cardiac ultrasound in the diagnosis of CCHD,but ultrasound is still the most widely used and most practical examination method.Ultrasound combined with CTA can effectively improve the diagnostic value of CCHD.It is recommended to use CTA as the follow-up examination of cardiac ultrasound so as to improve the diagnostic effects of CCHD.