低剂量宽体探测器CT一站式心脏成像评价复杂先天性心脏病婴幼儿左心功能

目的 探讨低剂量宽体探测器CT（Revolution CT）一站式心脏成像评价复杂性先天性心脏病（CCHD）婴幼儿左心功能的价值。方法 采用Revolution CT对45例CCHD患儿行心脏全期相增强扫描，计算获得左心室收缩末期容积（LVESV）、左心室舒张末期容积（LVEDV）、左心室每搏输出量（LVSV）和左心室射血分数（LVEF），并与二维超声心动图（2D-ECHO）所测相同指标进行比较分析。比较高危组（n=26）与低危组（n=19）患儿Revolution CT左心功能各指标的差异，以二元Logistic回归分析左心功能指标与病情轻重程度的关系。记录并计算患儿接受的有效辐射剂量（ED）。结果 Revolution CT所测LVESV、LVEDV及LVSV均高于2D-ECHO（P均<0.05），LVEF低于2D-ECHO（P=0.003）。Revolution CT与2D-ECHO所测LVESV、LVEDV、LVSV及LVEF之间均呈正相关（r=0.800、0.830、0.871、0.708，P均<0.001）。高危组与低危组间Revolution CT所测LVESV、LVEDV和LVSV差异有统计学意义（P均<0.05），LVEF差异无统计学意义（P=0.395），且Logistic回归分析显示LVESV、LVEDV及LVSV是高危CCHD的危险因素（P均<0.05）。患儿接受的ED为0.30（0.26，0.35）mSv。结论 Revolution CT可在较低辐射剂量下实现解剖结构与心功能测量的一站式成像，对于CCHD术前评估、术式选择和预后判断均有重要价值。

Low dose one-stop cardiac imaging using wide-detector CT in evaluation on left ventricular function for infants with complex congenital heart disease

Objective To investigate the value of low dose one-stop cardiac imaging using wide-detector CT (Revolution CT) in evaluation on left ventricular function for infants with complex congenital heart disease (CCHD). Methods Totally 45 infants with CCHD underwent one-stop cardiac imaging using Revolution CT. The left ventricular functional parameters, including the left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular stroke volume (LVSV) and left ventricular ejection fraction (LVEF) were calculated and compared with those measured using two dimensional echocardiogram (2D-ECHO). The correlation between the results of CT and 2D-ECHO examination was analyzed. The differences of left ventricular functional parameters were compared between high-risk group (n=26) and low-risk group (n=19). Then the binary Logistic regression analysis was further performed. The radiation effective dose (ED) was recorded. Results LVESV, LVEDV and LVSV measured with CT were higher, while LVEF were lower than those measured with 2D-ECHO (all P<0.05). Positive correlation of LVESV, LVEDV, LVSV and LVEF was found between CT and 2D-ECHO, with r values of 0.800, 0.830,0.871 and 0.708, respectively (all P<0.001). There were significant differences of LVESV, LVEDV and LVSV between high-risk group and low-risk group (all P<0.05). However, there was no significant difference of LVEF between the two groups (P=0.395). Logistic regression showed that LVESV, LVEDV and LVSV were the risk factors of high-risk CCHD. ED was 0.30 (0.26, 0.35)mSv. Conclusion Revolution CT is able to achieve good morphological images of CCHD with low radiation dosage, meanwhile accurately one-stop assess the left ventricular function, showing considerable application value in preoperative evaluation, surgical selection and prognosis of CCHD.