64层螺旋CT在小儿复杂型先天性心脏病诊断中的应用

目的探讨64层螺旋CT（64-MSCT）在小儿复杂型先天性心脏病（CCHD）诊断中的应用价值。方法回顾性分析22例经手术证实的CCHD患儿的临床资料,患儿术前均行64-MSCT非心电门控双期对比增强心血管成像,并在图形工作站完成多平面重组（MPR）、最大密度投影（MIP）及三维容积重现（VR）处理,所有患儿同期均进行超声心动图检查。以手术结果为金标准评价两种方法的诊断正确率。结果经手术证实心脏部分、心脏-大血管连接部分和大血管部分三段病变分别有41、23、37处,64-MSCT和超声心动图对以上三段畸形的诊断正确率分别为为94.81%、95.45%、98.76%和99.35%、99.09%、97.93%,总诊断准确率分别为96.84%和98.62%,64-MSCT检查与手术结果具有较高一致性（K=0.90,P〈0.05）。结论 64-MSCT是小儿CCHD检查的一种良好的无创影像技术,对绝大多数患儿术前治疗方案的制定、降低手术风险有一定辅助作用。

The Application of 64-multislice Spiral CT in the Diagnosis of Complex Congenital Heart Disease in Children

Objective To evaluate the advantage and limitation of 64-multislice spiral computed tomography（64-MSCT） in the diagnosis＇of complex congenital heart disease（CCHD） in children. Methods A retrospective analysis on the data of 22 patients was taken,who underwent the examinations of non-ECG-gated 64-MSCT cardioangiography with biphasic contrast,three-dimensional reconstruction were performed with multiplanar reformation（MPR）,maximum intensity projection（MIP） and volume rendering（VR）.All patients underwent echocardiography before the operations,the results of which were regard as the golden standard to evaluate those of 64-MSCT and echocardiography.Results There were 41 intracardiac deformities,23 abnormal connection of atrium or ventricle to great vessels and 37 vessel a-nomalies, which were confirmed by surgery.The diagnostic accuracy of 64-MSCT and echocardiography for the three paragraphs were 94.81%,95.45%,98.76%and 99.35%,99.09%,97.93%respectively, the total were 96.84%and 98.62%,the results of 64-MSCT and operations had high consistency（K = 0.90,P〈0.05）.Conclusion As a non-invasive cardioangiography technique for CCHD of children, 64-MSCT plays a certain role in the preoperation treatment program development and reduce the risk of the operation.