协和医学杂志

2011, v.2(03) 200-204

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双源计算机断层摄影对先天性心脏病的诊断
Dual-source Computed Tomography for the Diagnosis of Patients with Congenital Heart Disease

王怡宁;孔令燕;苗齐;方理刚;李烁;周慷;王志伟;徐凯;樊红苓;金征宇;
WANG Yi-ning1, KONG Ling-yan1, MIAO Qi2, FANG Li-gang3, LI Shuo1, ZHOU Kang1, WANG Zhi-wei1, XU Kai1, FAN Hong-ling1, JIN Zheng-yu1 1Department of Radiology,2Department of Cardiac Surgery,3Department of Cardiolory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

摘要(Abstract):

目的探讨双源计算机断层摄影(dual-source computed tomography,DSCT)诊断先天性心脏病(先心病)的临床应用价值。方法 DSCT增强扫描检查先心病患者20例,年龄4个月~53岁,平均19岁;所有病例均以心脏超声(echocardiography,ECHO)为对照,并经手术证实。结果 20例患者经手术证实的心内外结构畸形共63处,DSCT检出59处,诊断敏感性为93·7%;ECHO检出55处,诊断敏感性87·3%,两种方法诊断敏感性比较差异无统计学意义(χ2=1·474,P=0·225)。63处结构畸形中,心脏部分畸形41处,DSCT检出37处(90·2%),ECHO检出37处(90·2%),两者敏感性相当(P=1·000);心脏-大血管连接处畸形9处,DSCT检出9处(100%),ECHO检出8处(88·9%),差异无统计学意义(P>0·05);大血管部分畸形13处,DSCT检出13处(100%),ECHO检出10处(76·9%),差异无统计学意义(P>0·05)。结论 DSCT能够显示心内外结构畸形,具有较高的诊断敏感性,对先天性心脏病,特别是合并心外大血管畸形的诊断有重要价值。
Objective To evaluate the value of dual-source computed tomography (DSCT) in the diagnosis of congenital heart disease. Methods Twenty patients aged 4 months to 53 years (mean age 19 years) with congenital heart disease underwent contrast-enhanced DSCT. The results were compared with those of echocardiography (ECHO) and confirmed by surgery. Results Among the 20 patients, DSCT detected 59 of 63 (93.7%) anomalies that confirmed by surgery, and ECHO detected 55 of 63 (87.3%) (χ2=1.474, P=0.225). In the 41 intracardiac anomalies, DSCT was as sensitive as ECHO (both 90.2%, P=1.000). In the 9 heart-vessel conjunction deformities, no significant difference was found between the sensitivities of two modalities (100% vs. 88.9%, P>0.05). In the 13 great vessel deformities, no significant difference was found between the sensitivities of two modalities (100% vs. 76.9%, P>0.05). Conclusion DSCT detects intraand extra-cardiac anomalies with high sensitivity and has an important value in the diagnosis of congenital heart disease especially those with extra-cardiac anomoalies.

关键词(KeyWords): 心脏缺损,先天性;断层摄影术,X线计算机;超声心动描记术
heart defects, congenital; tomography, X-ray computed; echocardiography

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作者(Author): 王怡宁;孔令燕;苗齐;方理刚;李烁;周慷;王志伟;徐凯;樊红苓;金征宇;
WANG Yi-ning1, KONG Ling-yan1, MIAO Qi2, FANG Li-gang3, LI Shuo1, ZHOU Kang1, WANG Zhi-wei1, XU Kai1, FAN Hong-ling1, JIN Zheng-yu1 1Department of Radiology,2Department of Cardiac Surgery,3Department of Cardiolory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

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