128层MSCT虚拟仿真内镜技术在婴幼儿先天性心脏病的应用

目的:探讨128层MSCT虚拟仿真内镜技术(VE)对婴幼儿先天性心脏病的诊断价值.方法:回顾性分析67例先天性心脏病患儿128层螺旋CT和经胸壁超声心动图(TTE)资料,并与手术结果作对照.采用5分单盲法评价VE图像质量,比较心房心室和大血管的差异,建立VE飞行路径规划.结果:VE诊断主要心脏结构异常的总符合率51.7...

Application of 128-slice MSCT with virtual endoscopy in infants and children with congenital heart dis- ease

Objective:To explore the value of 128-slice MSCT with virtual endoscopy in the diagnosis of infants and children with congenital heart disease,as well as flight path planning and clinical application.Methods:The 128-slice spiral CT and transthoracic echocardiography(TTE)data of 67 children with congenital heart disease were retrospectively analyzed and compared with the surgical results.The image quality of VE was evaluated by 5-point single blind method,and the differences between left and right atrioventricular and large arteries were compared,to establish the flight path planning.Results:The coincidence rate of VE in the diagnosing of important cardiac structural abnormalities was(51.7%~100%)and the sensitivity was(51.7%~100%),the coincidence rate of MPR was(53.3%~100%)and the sensitivity was(53.3%~100%),and the coincidence rate for TTE was(25.0%~100%)and the sensitivity was(25.0%~100%).The coincidence rate and sensitivity of VE and MPR were higher than TTE in the diagnosis of VSD,DORV,TGA,pulmonary artery stenosis,coronary artery malformation and vascular ring.But the coincidence rate and the sensitivity of VE in the diagnosing of atrial septal defect and patent foramen ovale were lower than TTE.VE was superior to MPR in the visibility of displaying structural abnormalities and the sense of three-dimensional space.From the comparison among different anatomic regions,there was a significant difference between RA and LV,RV,LA and large vessels in the image quality evaluation(P=0.000<0.01),also the score of LA has significant difference compared with RV(P=0.006<0.01)and large vessels(P=0.002<0.01).The VE image quality of large vessels was the best,followed by RV,LV,LA and RA.The left and right heart systems should be established separately in VE flight path planning.Conclusion:The 128-slice MSCT with VE can accurately display the structure abnormalities of cardiac cavity and large vessels in infants and children with congenital heart disease,especially for ventricular septal defect,conic artery trunk malformation and coronary artery origin,which is more accurate than TTE.VE has good visibility and three-dimensional space sense for displaying structural abnormalities,which is closer to the vision field of open-heart surgery and helpful for rational design of surgical plan.This is of great significance to improve the teaching level of virtual surgery and the communication between doctors and patients before surgery.