MSCT及三维重建技术在先天性肺动脉闭锁伴VSD诊断中的价值

【目的】探讨16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7例肺动脉闭锁伴室间隔缺损患者的多排螺旋CT（MSCT）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、容积再现和最大密度投影等三维重建）。7例患者均行超声心动图检查。5例有手术结果，2例经心血管造影证实。【结果】7例患者中，MSCT显示4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；1例为主肺动脉缺如、左右肺动脉无融合。7患者室间隔缺损均在膜周部。伴发畸形包括动脉导管未闭3例，发现大的体肺侧支动脉3例，右位主动脉弓2例，主动脉骑跨3例。【结论】MSCT及三维重建显示了肺动脉闭锁伴室间隔缺损的主要征象及并发畸形，可作为肺动脉闭锁伴室间隔缺损的首选检查方法。

Clinical Application of 16-slice CT in the Diagnosis of Pulmonary Artery Atresia and Ventricular Septal Defect

Objective]To evaluate the role of 16-slice computed tomography（CT） in the diagnosis of pul- monary artery atresia and ventricular septal defect. Methods]Seven patients diagnosed as pulmonary artery atresia and ventricular septal defect by 16-slice CT were analyzed retrospectively. Multi planar reconstruction （MPR）, curved pianar 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. Five patients were confirmed by operation, 2 by angiocardiography （ACG）. Results] In the 7 patients, 16 slice CT showed that 4 patients were the atresia of proximal pulmonary artery and 3 were absent pulmonary artery. The accompanied abnormalities contained 2 patent ductus arteriosus, 7 major aorta pulmonary collateral arteries, 2 right aortic arch and 3 overriding of the aorta. Conclusion] 16-slice CT with 3-D reconstruction can present the main and accompanied abnormalities, so it can be chosen as the first method in the diagnosis of pulmonary artery atresia and ventricular septal defect.