64层CT对先天性心脏病肺动脉发育异常的术前评价

目的 前瞻性研究64层CT心血管造影评价先天性心脏病肺动脉发育异常的可行性和准确性. 资料与方法对心脏超声诊断先天性心脏病并临床怀疑有肺动脉发育异常的49例患儿于手术前7天内行64层CT心血管造影榆查.对所有各向同性扫描的薄层图像行任意方向多平面重组(MPR)及容积再现(VR)重组以显示肺动脉形态及密度,并与手术所见对照分析.结果 49例先天性心脏病患儿术前心血管CT造影诊断肺动脉发育异常42例,其中肺动脉扩张6例,肺动脉广泛变细8例,肺动脉局限性狭窄18例,肺动脉闭锁6例,肺动脉部分缺如4例.与手术结果对照,64层CT造影诊断肺动脉发育异常的敏感性为96.2%,特异性为99.3%,阳性预测值为96.2%,阴性预测值为99.3%,准确性为98.8%.结论 64层CT心血管造影是评价先天性心脏病肺动脉发育异常的可行和准确的方法.

The Preoperation Evaluation of Pulmonary Artery Dysplasia in Congenital Heart Disease by 64-slice CT

Objective To study prospectively the feasibility and accuracy of preoperation evaluation of pulmonary artery dysplasia in congenital heart diseases by 64-slice CT. Materials and Methods 49 patients who were diagnosed congenital heart diseases by ultrasound and doubt of pulmonary artery dysplasia were performed heart angiography by 64-slice CT. Two-dimensional and three-dimensional reconstructions were performed using isotropic data in all cases by means of MPR and VR to show the shape and density of pulmonary arteries. The results were analyzed and compared with surgical operation. Results 42 cases of pulmonary arteries dysplasia were diagnosed in 49 patients of congenital heart diseases by CT cardiovascular angiography before surgical procedures. 64-slice CT angiography diagnosed 6 cases of pulmonary artery dilation, 8 cases of extensive stenosis of pulmonary artery,18 cases of focal pulmonary artery stenosis,6 cases of pulmonary artery atresia, 4 cases of fight or left pulmonary artery absence. Comparing with the results of surgical procedures,for the diagnosing of pulmonary dysplasia by 64-slice CT,the sensitivity is 96.2% ,the specificity is 99.3%, the positive predictive value is 96.2%, negative predictive value is 99.3%, the accuracy of diagnosis is 98.8%. Conclusion 64-slices spiral CT cardiovascular angiography is a feasible and accurate approach to diagnose dysplasia of pulmonary artery in congenital heart diseases.