新生儿心脏病的磁共振检查

目的:探讨磁共振(MR)检查技术对新生儿先天性心脏病(先心病)的诊断灵敏度。方法:对82例新生儿先心病行心脏MR检查。检查所用设备为GEEchospeed1.5TMR扫描仪,每例均作自旋回波T1W序列、梯度回波电影序列和造影增强的MR血管成像(CE-MRA)序列。患儿年龄2～28d,平均15d。结果:新生儿心脏MR检查均获成功,82例中74例经手术或活检证实,其中70例MR诊断与手术结果符合,诊断灵敏度为94.6%。82例中主动脉缩窄(COA)18例,主动脉弓中断(IAA)7例,肺静脉连接完全异常(TAPVC)8例。另外,对有严重复杂先心病和心脏肿瘤患儿也常规采用心脏MR检查。结论:新生儿心脏MR检查相当安全,诊断符合率也很高,CE-MRA是梗阻性先天性主动脉弓畸形和梗阻性TAPVC的最佳非创伤诊断手段。新生儿心脏MR检查的常见病种与成人和儿童均有所不同。

Magnetic resonance imaging in neonatal cardiac diseases

Objective To evaluate the magnetic resonance imaging (MRI) technique in neonates and the imaging diagnostic accuracy in congenital cardiac diseases. Methods Magnetic resonance examinations were performed for diagnosis of the cardiac anomalies in 82 neonatal cases from September 1999 to September 2005. All the examinations were performed with a GE Echospeed 1.5T MR unit. T1-weighted spin-echo sequence, gradient-echo cine sequence and contrast enhancement magnetic resonance angiography (CE-MRA) were performed in every case. The age of the patients ranged from 2 days to 28 days and the mean age was 15 days. Results All the magnetic resonance examinations were successfully carried out. Of the 82 patients, 18 were diagnosed with coarctation of aorta (COA), 7 with interruption of aortic arch (IAA) and 8 with total anomalous pulmonary venous connection (TAPVC). Severe complex congenital heart diseases and cardiac tumor were also commonly seen. Seventy-four cases had been operated, and the results showed the diagnostic sensitivity for neonatal cardiac diseases was 94.6% (70/74). Conclusions Magnetic resonance imaging is safe and reliable to diagnose the neonatal cardiac diseases. CE-MRA may be the best noninvasive diagnostic modality for congenital obstructive aortic arch anomalies and congenital obstructive total anomalous pulmonary venous return. The cardiac disease types of neonates are different from both adults and children.