64层螺旋CT诊断肺动脉闭锁伴室间隔缺损的探讨

目的探讨64层螺旋CT在先天性肺动脉闭锁伴室间隔缺损诊断中的应用价值。方法对11例肺动脉闭锁伴室间隔缺损患者64层螺旋CT资料进行回顾性分析，并与超声心动图和手术结果对照。所有病例均行多平面重建和容积再现等三维重建。11例患者均行超声心动图检查。6例有手术结果，1例经心血管造影证实。结果11例患者中，64层螺旋CT显示5例为主肺动脉近端闭锁；2例为主肺动脉缺如，左右肺动脉尚有融合；4例为主肺动脉缺如、左右肺动脉无融合，其中2例左右肺动脉未见显示。11患者室间隔缺损均在膜周部。伴发畸形包括动脉导管未闭4例，发现大的体肺侧支动脉8例，右位主动脉弓2例，主动脉骑跨3例。结论64层螺旋CT及三维重建显示了肺动脉闭锁伴室间隔缺损的主要及并发畸形，可作为肺动脉闭锁伴室间隔缺损的首选检查方法。

The clinical application of 64 MSCT in the diagnosis of pulmonary atresia and ventricular septal defect

Objective To evaluate the role of 64-slice computed tomography （CT） in the diagnosis of pulmonary atresia and ventricular septal defect. Methods 11 patients diagnosed as pulmonary atresia and ventricular septal defect by 64-slice computed tomography were retrospectively analyzed. Multi-planar reconstruction（MPR）, curved-planar reconstruction（CPR）,volume render （VR）, maximum intensity projection （MIP） and minimum intensity projection （MinIP） were performed in all patients. Meanwhile, ultrasound echocardiography（UCG） was performed on all patients. 6 patients were confirmed by operation, 1 by angiocardiography（ACG）. Results In the 11 patients, 64-slice CT showed 5 patients with the atresia of proximal pulmonary artery, 6 with the absent pulmonary artery. The accompanied abnomalities contain 4 patent ductus arteriosus, 8 major aorta-pulmonary collateral arteries, 2 right aortic arch, 3 overriding of the aorta. Conclusion 64-slice CT with 3-D reconstruction showed the main and accompanied abonormalities, can be chosen as the first method in the dianosis of pulmonary atresia and ventricular septal defect.