多层螺旋CT血管造影与超声心动图对复杂性先天性心脏病的诊断价值

目的分析多层螺旋CT血管造影（multislicespiralcomputedtomographyangiography，MSCTA）与超声心动图（ultrasoniccardiogram，UCG）在复杂性先天性心脏病（complexcongenitalheartdisease，CCHD）诊断中的价值。方法作者医院经手术证实的CCHD患者病例35例，所有病例术前均同期行MSCTA及UCG检查，并与手术结果进行对照，对比分析MSCTA和UCG的诊断符合率。结果35例CCHD病例术后共发现心脏畸形131处，其中心内畸形66处，心外畸形65处。MSCTA检出心内畸形60处，符合率为91％（60／66），UCG检出心内畸形64处，符合率为97％（64／66），差异无统计学意义（P=0．274〉0．05）。MSCTA检出心外畸形64处，符合率为98％（64／65），UCG检出心外畸形56处，符合率为86％（56／65），二者具有统计学差异（P=0．021〈0．05）。结论MSCTA在显示心内畸形方面与UCG具有同等价值，在心外大血管畸形方面较UCG更有优势，对静脉畸形（腔静脉和肺静脉）的显示更为直观。

Diagnostic Value of MSCTA and UCG for Complex Congenital Heart Disease

Objective To explore the diagnositic value of multislice spiral computed tomography angiography （MSCTA） and ultrasonic cardiogram （UCG） for complex congenital heart disease （CCHD）. Methods The medical re- cords of 35 patients with proved CCHD by surgery were reviewed. All patients accepted MSCTA and UCG examination, and the examination results were compared with the surgery findings. The accuracy rates of MSCTA and UCG were com- pared. Results A total of 131 heart deformities were found in 35 patients, 66 were cardiac deformities, 65 were extracar- diac anomalies. The diagnostic accuracy of MSCTA and UCG for cardiac deformities were 91% （60/66） and 97% （64/ 66） and there was no significant difference （P = 0. 274±0. 05）. The diagnostic accuracy for extracardiac anomalies were 98% （64/65） and 86% （56/65）, which were significantly different （P = 0. 021±0. 05）. Conclusion MSCTA has the same value as UCG in displaying the cardiac deformities, and is superior to UCG in the diagnosis of extracardiac anoma- lies, especially in venous malformation （vena cava and pulmonary veins）.