双源64层CT与经胸超声心动图在诊断复杂先天性心脏病中的对照研究

目的:探讨双源64层CT（DSCT）在诊断复杂先天性心脏病(CCHD)中的应用价值，并与经胸超声心动图（TTE）进行对照研究。方法: 对186例CCHD患者同期行DSCT和TTE检查，以手术结果为标准，在心内异常解剖、心外大血管畸形的诊断上进行回顾性分析。结果: 手术证实心血管畸形共538处。DSCT检出506处，检出率为94.1%，TTE检出497处，检出率 为92.4%，两者差异无统计学意义，但两者联合检查检出529处，检出率达98.3%，明显高于单项检查（P<0.01）。其中，①心脏部分畸形:共 209处，DSCT检出190处，检出率为90.9%，TTE检出200处，检出率为 95.7%，两者差异无统计学意义；②心脏-大血管连接部分异常:共103 处，DSCT检出94 处，检出率为91.3%，TTE检出91处，检出率为88.4%，两者差异无统计学意义；③大血管部分畸形:共226处，DSCT检出222处，检出率为98.2%，TTE检出 206处，检出率为91.1%，两者差异有统计学意义（P<0.01），DSCT检出率显著高于TTE。结论: ①DSCT诊断心外大血管畸形的检出率高于TTE，对可疑并发大血管畸形的复杂先天性心脏病应作为常规检查手段；②DSCT与TTE联合应用可提高CCHD术前诊断的检出率。

Control study of dual-source computed tomography and ultrasound cardiography in diagnosis of complex congenital heart diseases

AIM: To evaluate the clinical value of dual-source computed tomography(DSCT) in diagnosis of complex congenital heart diseases(CCHD) using a control study with transthoracic ultrasound cardiography(UCG).METHODS: DSCT and UCG were performed in 186 patients with CCHD and their diagnosis of cardiovascular anomalies was later surgically confirmed and compared.RESULTS: In all patients,538 cardiovascular anomalies were confirmed.Accuracy of DSCT and UCG was 94.1% and 92.4%,respectively,and diagnostic accuracy showed no statistical difference(P=0.281).Of the 209 confirmed intracardiac anomalies,DSCT detected 190(90.9%) and UCG detected 200(95.7%),with no statistical difference in the diagnostic accuracy rate(P=0.052).Of the 103 confirmed heart-vessel conjunction anomalies,DSCT detected 94(91.3%) and UCG detected 91(88.4%),also with no statistical difference in the diagnostic accuracy rate(P=0.629).Of the 226 confirmed great vessel anomalies,statistical difference was observed in the diagnostic accuracy between the 222(98.2%) detected by DSCT and the 206(91.1%) detected by UCG(P<0.01),showing that DSCT was superior to UCG.CONCLUSION: DSCT is superior to transthoracic UCG in the diagnosis of great vessel anomalies and can be used as one of the non-invasive conventional preoperative detection methods for CCHD.Use of DSCT combined with UCG can improve the diagnostic accuracy of CCHD.