摘要
目的探讨双源CT(dual-source CT,DSCT)评价婴幼儿复杂先天性心脏病肺动脉情况的准确性及临床应用价值。资料与方法对临床拟诊先天性心脏病的患儿同期行DSCT和超声心动图(ultrasound cardiography,UCG)检查,检查前均未服用β-受体阻滞剂。取年龄<1岁、经手术证实有肺动脉发育异常的患儿19例为观察对象,以手术结果为标准,从主肺动脉、左肺动脉、右肺动脉、左右肺动脉汇合、肺动脉狭窄、未闭动脉导管及主肺侧支血管等方面回顾比较两种检查方法的显示能力,并评价其主要测量结果的相关性。结果DSCT原始图像及三维重组图像清晰,并可多角度、任意层面地进行观察,对肺动脉发育和血供来源的显示优于UCG(DSCT总体性能参数:敏感性93%,特异性97%,阳性预测值99%,阴性预测值83%;UCG总体性能参数:敏感性79%,特异性80%,阳性预测值92%,阴性预测值57%),两者测量结果具有较高的相关性(相关系数:主肺动脉0.97,左肺动脉0.96,右肺动脉0.92)。结论不对心率进行干预,评价婴幼儿肺动脉及分支的变异和发育情况,DSCT优于UCG。
Objective To investigate the clinical value and accuracy of DSCT in the assessment of the pulmonary arteries in infants with complex congenital heart disease.Materials and Methods DSCT and echocardiography was performed respectively in infants with complex congenital heart disease.βreceptor block agent was not required.19 patients younger than 1 years were collected,whose pulmonary arteries were abnormal by operation.7 aspects were concerned,including pulmonary trunk,left pulmonary,right pulmonary,confluence of pulmonary,stenosis of pulmonary,patent ductus arteriosus and major aortopulmonary collateral arteries.The results were compared with each other to evaluate the ability of manifestation of the pulmonary arteries and reveal their relevance.Results The pulmonary arteries could be clearly observed from original images and multi-planar reconstruction images at different angles.DSCT was superior to echocardiography for the noninvasive assessment of pulmonary artery anatomy（overall test parameters of DSCT：sensitivity 93%,specificity 97%,PPV 99%,NPV 83%;overall test parameters of echocardiography： sensitivity 79%,specificity 80%,PPV 92%,NPV 57%）.A high correlation was obtained from measurements（coefficient of correlation：main pulmonary artery 0.96,left pulmonary artery 0.97,right pulmonary artery 0.92）.Conclusion Disregarding heart rate,DSCT is superior to echocardiography for the assessment of pulmonary artery anatomy.
出处
《临床放射学杂志》
CSCD
北大核心
2009年第10期1430-1434,共5页
Journal of Clinical Radiology
