64层螺旋CT三维后处理成像应用于心外结构异常诊断的特点

背景：先天性心脏病心外结构异常的超声诊断受范围限制影像学检查缺乏整体观,而多层螺旋CT检查具有直观、准确显示整体的优势。目的：探讨64层螺旋CT三维成像评价先天性心脏病心外结构异常图像质量与伪影的影响。方法：回顾性分析经手术证实的先先天性心脏病患者23例,按5级评分法分析术前心脏CT图像质量,比较CT、超声心动图及手术结果。结果与结论：①大于6岁年龄组CT图像质量优于小于6岁年龄组,有心电门控模式的图像优于无心电门控模式。②23例心外结构异常共41处,三维螺旋CT、超声心动图及二者联合诊断正确率分别为97.56%,72.97%及100%,组间比较差异有非常显著性意义(P < 0.01),说明螺旋CT诊断范围较超声心动图广,心外血管结构异常诊断准确率高,二者结合效果更好。容积再现成像较多平面成像能更准确显示心外结构异常(P < 0.01);最小密度投影成像仅适用于气管支气管结构异常诊断,表明不同的螺旋CT后三维处理成像技术对不同种类先天性心脏病心外结构异常有不同的应用优势。

Application of 64-slice spiral CT three-dimensional post-processing image for the diagnosis of the extracardiac structural anomalies

BACKGROUND:Echocardiography (ECHO) is limitied to diagnose extracardiac structural anomalies of congenital heart disease (CHD). However, compared with ECHO, multi-slice spiral CT (MSCT) has advantages of detecting the extracardiac structural anomalies intuitively and accurately.OBJECTIVE:To explore the influence of cardiac image quality and artifacts of extracardiac structural anomalies by 64-MSCT examination.METHODS:Totally 23 patients after CHD surgery were reviewed. Cardiac image quality was evaluated by five-grade score before the surgery. CT, ECHO and surgical results were compared.RESULTS AND CONCLUSION:① The cardiac image quality in the greater than 6-year-old age group was better than that in the less than 6-year-old age group. The images of electrocardiograph-gated technique was superior to that of non-electrocardiograph-gated technique. ② In the 23 patients, there were 41 extracardiac structural anomalies. The diagnosis accurate rates of 64-MSCTA, ECHO and combination diagnosis were 97.56%, 72.97% and 100% respectively. There was significant difference between any two methods (P < 0.01). It is showed that 64-MSCT had advantages of detecting the extracardiac structural anomalies intuitively and accurately. Diagnosis range of 64-MSCTA was larger than that of ECHO. 64-MSCTA combined with ECHO could obtain better effect. There was significant difference between the accurate rates of volume rengdering imaging and multiplanar reformation imaging (P < 0.01). Minimum intensity projection was only appropriate for congenital tracheobronchial structural anomalies. So, it is indicated that there are different advantages in diagnosis of extracardiac structural anomalies by different MSCT post-processing reconstruction techniques.