摘要
目的 :评价电子束计算机断层摄影术 (EBCT)在小儿复杂先天性心脏病 (先心病 )诊断中的价值。 方法 :对 2 6例患者经胸常规超声心动图 (TTE)诊断为复杂先心病 ,同时做 EBCT增强单层容积扫描 ,并由计算机工作站进行图像三维重建。其中 9例又做了常规心血管造影 ,11例经外科手术 ,进行对照研究。 结果 :全组 11种复杂先心病共 6 1处畸形 ,其中心内畸形 2 1处 ,EBCT与 TTE均作出正确诊断。然而 ,心外大血管畸形及心室—大血管连接异常诊断中两者有明显差别 ,在 40处畸形中 ,EBCT过多诊断 1处 (动脉导管未闭 ) ,手术证实为假阳性 ,EBCT诊断符合率为 97.5 % (39/ 40 ) ;TTE诊断 35处 (误诊 1处 ,漏诊 4处 ) ,TTE诊断符合率 87.5 % (35 / 40 )。EBCT与TTE诊断的正确率有显著差异 (χ2 =3.936 ,P<0 .0 5 )。TTE与 EBCT相结合使诊断的总准确率提高到 98.4% (6 0 / 6 1)。 结论 :EBCT对复杂先心病中某些畸形的检出优于 TTE。EBCT血管造影与 TTE及心血管造影相结合 ,可提高对复杂先心病诊断的准确率 ,以指导手术。
Objective:To evaluate eletron beam computed tomography in the diagnosis of pediatric complex congenital heart disease. Method:Twenty six patients (16 males and 10 females) were suspected complex congenital heart disease.The range of age was from 5 month to 9 5 years with mean age of 3 1 years.EBCT single scan mode was performed on 26 patients whom had been diagnosed with complex congenital heart disease by means of conventional transthoracic echocargiography (TTE),and EBCT three dimensional reconstruction was done in the workstation.In this group,angiocardiography was also performed on 9 patients and operation on 11 patients. Results:Among the 26 cases (associated with 61 anomalies in 11 kinds of complex congenital heart disease),correct diagnosis of 11 kinds of complex congenital heart disease with 21 intracardiac abnormalities of 61 anomalies was made by both EBCT and TTE.There was significant difference between EBCT and TTE in the identification of extracardiac anomalies and ventriculo arterial connections.One anomaly (patent ductus arteriosus) was over estimation of diagnosis by EBCT and finally confirmed to be false positive by operation.The correct diagnosis rate of EBCT was 97 5%(39/40).TTE accurately diagnosed 35 anomalies,misdiagnosed 1 anomaly and overlooked 4 anomalies.The correct diagnosis rate of TTE was 87 5%(35/40).There was significant difference between EBCT and TTE( x 2=3 936, p <0 05).However,the combination of EBCT and TTE raised the correct diagnosis rate to 98 4%(60/61). Conclusion:EBCT is superior to TTE in the detection of some complex congenital heart disease.The combination of EBCT with TTE and/or angiocardiography can raise the correct diagnosis rate of complex congenital heart disease and be helpful in surgery.
出处
《中国循环杂志》
CSCD
北大核心
2000年第3期174-176,共3页
Chinese Circulation Journal
关键词
先天性心脏病
EBCT
诊断
儿童
Tomography X ray computed
Three dimensional reconstruction
Heart defect congenital
