多层螺旋CT血管造影在重症婴幼儿法洛四联症中的诊断价值

目的 探讨多层螺旋CT血管成像评价重症婴幼儿法洛四联症的临床应用价值。方法 对2010年1月至2013年3月45例重症婴幼儿法洛四联症的患者术前行256层螺旋CT检查,34例行心电门控扫描,11例行普通扫描,所有病例均经后处理工作站进行分析,使用多平面重建(MPR)、最大密度投影(MIP)、容积重建(VR)和薄层图像进行综合评估,同时与经胸超声心动图(TTE)及手术结果对照。结果 45例患者中,手术证实256层螺旋CT畸形准确43例,TTE准确34例;其中TTE漏诊动脉导管未闭4例;主动脉缩窄7例;同时CT显示4例体肺动脉粗大侧枝。256层螺旋CT与TTE诊断的准确率分别为95.6%(43/45)、75.6%(34/45),两种检查方法准确率比较,差异有统计学意义(P < 0.05)。结论 256层螺旋CT可作为重症婴幼儿法洛四联症术前诊断及合理制定手术方案的重要依据。

The Value of Diagnosis with the Multi-Slice Spiral CT in Sever Tetralogy of Fallot of Infant

Objective To study the value of diagnosis with the multi-slice spiral CT in severe tetralogy of fallot of infant. Methods From January 2010 to March 2013,45cases (sever Tetralogy of Fallot of infant) were examined with 256-slice spiral CT preoperativly. All cases were then analyzed in work station with MPR(multiplanar recon-struction)、MIP (maximum intensity projection)、VR (volume rendering) and thin slice images,while compared with TTE (transthoracic echocar-diography) and surgical results. Results CT examination found that TTE misdignozed 4 cases of ductus arteriosus and 7cases of aortic coarctation. Meanwhile,CT shows 4 cases aorta pulmonary collateral arteries. In 45cases, surgical results confirmed 43 cases by 256-slice spiral CT, while 34 cases by TTE. The diagnosis accuracy of 256-slice spiral CT and TTE was respectively 95.6% (43/45) and 75.6% (34/45). There was statistically significant difference (P < 0.05) of the two inspections in diagnostic accuracy. Conclusion The inspection of 256-slice Spiral CT can benefit the preoperative diagnosis and operation program in severe infant with Tetralogy of Fallot.