64排螺旋CT血管造影诊断法洛四联症

目的探讨64排螺旋CT血管造影(64-SCTA)诊断法洛四联症(TOF)的价值。方法回顾性分析54例法洛四联症患者的CT资料,并进行不同方式重建,包括MPR、CPR、MIP和VR等,并与心脏超声(UCG)和手术结果相比较。结果 64-SCTA和UCG均可显示TOF的4种主要畸形。44例经手术证实的TOF中,64-SCTA显示TOF主要畸形的准确率为98.86%(174/176),UCG为97.16%(171/176),二者的差异无统计学意义(P0.05);对TOF伴发心外畸形的显示率为91.12%(62/68),明显优于UCG(χ2=21.76,P0.01)。结论 64-SCTA三维重建图像能清楚显示TOF的心外大血管结构异常及其合并畸形,尤其能判断肺动脉有无狭窄和评价冠状动脉起源,对选择手术方案有重要参考价值。

64-slice spiral CT angiography in diagnosis of tetralogy of Fallot

Objective To explore the value of 64-slice spiral CT angiography （64-SCTA） in diagnosis of tetralogy of Fal- lot （TOF）. Methods Fifty-four patients diagnosed as TOF by 64-slice CT were analyzed comparatively with outcomes of cardiac ultrasound and surgery. MPR, CPR, MIP and VR were used to reconstruct image. Results Four major malforma- tions of TOF could be accurately diagnosed by both 64-SCTA and cardiac ultrasound. In 44 patients with TOF proved by surgery, 64-SCTA for diagnosing four major malformations of TOF was 98.86% （174/176）, and then the UCG was 97.16% （171/176）, no statistical difference was found between 64-SCTA and UCG （P〈0.05）. The diagnostic accuracy of 64-SCTA in diagnosing extracardiac vascular abnormalities was 91.12% （62/68）, higher than that of UCG （x2=21.76, P〈0.01）. Conclusion The 64-SCTA with 3D reconstruction can clearly display anatomical and extracardiac vascular ab- normalities, especially for pulmonary artery stenosis and anomalies, therefore being valuable for planning operative proce- dure in patients with TOF.