摘要
目的探讨双源CT(DSCT)前瞻性心电门控技术在婴幼儿先天性心脏病(简称先心病)的诊断价值。方法回顾性分析DSCT检查并经手术治疗的先心病患儿46例,按照CT扫描方法的不同,分为前瞻性心电门控扫描组(A组)及回顾性心电门控扫描组(B组)。由两名有经验的医师原始图像进行重建,并对图像进行诊断。以手术结果为标准,比较两组不同扫描方式对于婴幼儿心内畸形、心脏大血管连接畸形、心外大血管畸形诊断的准确率差异。收集所有患儿辐射剂量参数CTDI、DLP和ED,并进行组间比较。结果46例先心病患儿,经手术证实存在心血管畸形225处,其中心内部分畸形96处、心脏大血管连接畸形34处、心外大血管畸形107处。在不同扫描方式下,心内畸形、心脏大血管连接、心外大血管畸形诊断准确率分别为:A组72.1%(31/43)、93.8%(15/16)、93.5%(43/46),B组69.8%(37/53)、83.3%(15/18)、95.1(58/61),两组同一解剖部位畸形诊断准确率χ^2值分别为0.060、0.123、0.033,P>0.05,差异无统计学意义。两组CTDI、DLP、ED分别为:A组(2.97±0.85)mGY、(32.95±12.28)mGy/cm、(0.46±0.17)mSv,B组(3.95±1.09)mGY、(54.12±16.07)mGy/cm、(0.75±0.22)mSv,两组间比较A组辐射剂量明显低于B组,差异有统计学意义。结论双源CT前瞻性心电门控扫描技术,降低患儿辐射剂量的同时能够满足图像质量与临床诊断的需求,可广泛用于婴幼儿先天性心脏病的诊断。
Objective To explore the clinical application of of dual-source CT(DSCT)ECG gating CT cardiac angiography(CTA)in diagnosing congenital heart disease(CHD).Methods A retrospective analysis was condncted form January 2016 to July 2017 DSCT on examination and the surgical treatment of children with 46 cases,prospective heart scan(group A)and A retrospective heart scan(group B).CTDI parameters between the two groups,differences in DLP and ED were analyzed using independent sample mean t test.The original image was reonstructed by two experienced doctors rebuilt,and made the image diagnosis.All cases were confirmed by surgery.On the basis of surgical results.We compared two groups of different scanning mode for infant and young child heart malformation,heart,great vessels connecting deformity,the correct rate of diagnosing heart outside big vascular malformation.Results CTDI,DLP and ED in groups A and B were(2.97±0.85)mgy,(32.95±12.28)mgy/cm and(0.46±0.17)msv,respectively(3.95±1.09)mGY,(54.12±16.07)mGY/cm,(0.75±0.22)mSv;Group A had significantly lower CTDI,DLP and ED than group B,with statistically significant differences(t=3.323,4.942,4.942,P<0.05).225 cases(93 cases in group A and 132 cases in group B,with an overall DSCT diagnosis accuracy of 84%)were confirmed by surgery.Intracardial malformations the detection accuracy of group A and group B was 72.1%and 69.8%.Malformation of connection of great vessels in heart the detection accuracy of group A and group B was 93.8%and 83.3%,respectively.Extracardial macrovascular malformation the detection accuracy of group A and group B was 93.5%and 95.1%.On the basis of surgical results,two types of scan in cardiology deformity,heart big vascular malformation,the heart of the connection the diagnostic accuracy of vascular malformation had no statistical differences(χ^2=0.060,0.123,0.033,P>0.05).Conclusion Dual-source CT low-dose prospective electrocardiogram technique can be used to evaluate the morphological changes of congenital heart disease and provide accurate information for clinic.
作者
陈伟
杜靖
吕飙
王文川
CHEN Wei;DU Jing;LYU Biao;WANG Wenchuan(Department of Imaging, Beijing Shunyi District Hospital, Beijing 101300, P.R China;Department of Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R China)
出处
《医学影像学杂志》
2020年第8期1361-1364,共4页
Journal of Medical Imaging
