| 侯洁,肖俊睿,孙玉,刘畅,杨本强.MSCT诊断肺动脉闭锁伴室间隔缺损[J].中国医学影像技术,2018,34(4):528~532 |
| MSCT诊断肺动脉闭锁伴室间隔缺损 |
| MSCT in diagnosis of pulmonary atresia with ventricular septal defect |
| 投稿时间：2017-04-07 修订日期：2017-08-03 |
| DOI：10.13929/j.1003-3289.201704028 |
| 中文关键词: 肺动脉瓣闭锁 室间隔缺损 体层摄影术,X线计算机 |
| 英文关键词:Pulmonary atresia Heart septal defects,ventricular Tomography,X-ray computed |
| 基金项目:2015辽宁省国产医疗器械研发、评价与推广协同创新工程（2015305010）、2016国家工信部、卫计委两部委课题（2016MHD110002002101）。 |
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| 中文摘要: |
| 目的 探讨MSCT诊断肺动脉闭锁伴室间隔缺损（PA/VSD）的价值。方法 回顾性分析81例PA/VSD患者的临床及影像资料。将患者术前经胸超声心动图（TTE）、MSCT检查结果与手术结果对比。结果 PA/VSD A1型23例，A2型17例，B型34例，C型7例。MSCT诊断PA/VSD分型的准确率为93.82%（76/81），高于TTE[59.26%（48/81）；χ2=26.95，P<0.01]；MSCT诊断粗大主动脉及肺侧支循环动脉（MAPCAs）来源准确率为100%（93/93），高于TTE[51.84%（51/93）；χ2=54.25，P<0.01]。MSCT检出心内畸形50处（50/53，94.34%），TTE检出53处（53/53，100%），二者差异无统计学意义（χ2=1.37，P=0.24）；MSCT检出心脏-大血管连接异常66处（66/66，100%），TTE检出65处（65/66，98.48%），二者差异无统计学意义（P>0.05）；MSCT检出心外大血管异常106处（106/106，100%），高于TTE[82.08%（87/106）；χ2=20.87，P<0.01]。MSCT测量McGoon比值、肺动脉指数、全部新的肺动脉指数与手术所见比较差异均无统计学意义（P均>0.05）。结论 MSCT可准确诊断PA/VSD分型及肺血管发育情况，为临床诊疗提供指导。 |
| 英文摘要: |
| Objective To explore the value of MSCT in diagnosis of pulmonary atresia complicated with ventricular septal defect (PA/VSD). Methods Clinical and imaging data of 81 patients with PA/VSD were retrospectively analyzed. All patients underwent transthoracic echocardiography (TTE) and MSCT before surgical operation, and the imaging data were compared with surgical findings. Results There were 23 patients of type A1, 17 of type A2, 34 of type B and 7 of type C PA/VSD. The accuracy rate of MSCT classification of PA/VSD (93.82%[76/81]) was higher than that of TTE (59.26%[48/81]; χ2=26.95, P<0.01). The accuracy rate of MSCT diagnosis of origin of major aortopulmonary collateral arteries (MAPCAs, 100%[93/93]) was higher than that of TTE (51.84%[51/93]; χ2=54.25, P<0.01). Fifty cardiac malformations (50/53, 94.34%) were detected with MSCT, 53 with TTE ([53/53,100%];χ2=1.37,P=0.24), while 66 heart-vessel conjunction abnormalities (66/66, 100%) were detected with MSCT, and 65 with TTE ([65/66, 98.48%], P>0.05). Meanwhile, 106 extracardiac great vessel abnormalities (106/106, 100%) were detected with MSCT and 87 with TTE ([87/106, 82.08%], χ2=20.87, P<0.05). McGoon index, pulmonary artery index and total neo-pulmonary arterial indexes(TNPAI) measured with MSCT were not statistical different with findings of surgical operation (all P>0.05). Conclusion MSCT can accurately diagnose type of PA/VSD and display pulmonary artery developmental state, therefore providing guidance for clinical treatment of PA/VSD. |
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