双源CT门控下心胸联合血管成像诊断主动脉缩窄

目的 探讨双源CT(DSCT)门控下心胸联合血管成像在主动脉缩窄诊断中的价值。方法 对17例临床怀疑为主动脉缩窄患儿行DSCT门控下心胸联合血管成像,利用工作站对胸部血管及心脏分别进行靶重组,并对疾病进行诊断。所有患儿同时接受彩色多普勒血流显像(CDFI)检查。以手术或DSA结果为标准,对比DSCT与CDFI的诊断准确率。结果 17例患儿均成功完成DSCT门控下心胸联合血管成像,DSCT均诊断为主动脉缩窄,伴有室间隔缺损(VSD)者11例,伴有房间隔缺损(ASD)2例,伴有二叶型主动脉瓣及主动脉瓣发育不良者6例,伴有动脉导管未闭(PDA)者7例,伴有冠状动脉起源异常者3例,伴有支气管动脉扩张者4例。CDFI诊断主动脉缩窄16例,主动脉弓断离1例;伴有VSD者11例,伴有ASD者2例,伴有二叶型主动脉瓣及主动脉瓣发育不良者7例,伴有PDA者6例,2例显示支气管动脉扩张。所有患者均经手术或DSA证实,共发现畸形60处。DSCT和CDFI的诊断准确率分别为93.33%(56/60)和76.67%(46/60)。结论 DSCT门控下心胸联合血管成像可清晰显示主动脉、冠状动脉、心脏结构和肺血管,在主动脉缩窄及其并发症的诊断中具有重要价值。

Dual-source CT gated cardiothoracic angiography in diagnosis of aortic coarctation

Objective To explore the value of dual-source CT (DSCT) gated cardiothoracic angiography in the diagnosis of pediatric aortic coarctation (AoC). Methods Seventeen pediatric patients suspected with AoC underwent chest DSCT angiography and color Doppler flow imaging (CDFI). The accuracy of DSCT and CDFI were evaluated and compared with operation or DSA. Results All patients were diagnosed as AoC with DSCT gated cardiothoracic angiography, among them 11 were found complicated with ventricular septal defect (VSD), 2 with artial septal defect (ASD), 6 with malformations of aortic valve 7 with patent ductus arteriosis (PDA), 3 with abnormal coronary arteries,4 with bronchus artery dilation, sixteen patients were diagnosed AoC with CDFI, 1 was diagnosed with interrupted aortic arch. All VSD and ASD were detected with CDFI, 7 were found complicated with malformations of aortic valve, 6 with PDA and 2 with bronchus artery dilation. Compared with surgical operation or DSA, the diagnosed accuracy of DSCT and CDFI was 93.33% (56/60) and 76.67% (46/60), respectively. Conclusion Aorta, coronary, cardiac structure and pulmonary vascular can be displayed clearly with DSCT gated cardiothoracic angiography, which is a valuable method to diagnose pediatric aortic coarctation and complications.