| 殷磊,吕滨,韩磊,白桦,金敬琳,徐仲英,张戈军,杜瑞宾,蒋世良,戴汝平.双源CT术前定量分析肺动脉闭锁患者固有肺动脉及体肺侧支[J].中国医学影像技术,2010,26(6):1084~1087 |
| 双源CT术前定量分析肺动脉闭锁患者固有肺动脉及体肺侧支 |
| Quantitative analysis of native pulmonary artery and pulmonary collaterals in preoperative patients with pulmonary artery atresia with dual-source CT |
| 投稿时间：2009-11-17 修订日期：2010-02-03 |
| DOI： |
| 中文关键词: 肺动脉闭锁 体层摄影术,X线计算机 血管造影术 |
| 英文关键词:Pulmonary artery atresia Tomography, X-ray computed Angiography |
| 基金项目:福建省卫生厅青年科研课题(2009-2-8)。 |
| 作者 | 单位 | E-mail | | 殷磊 | 福建省立医院放射科,福建 福州 350001 | | | 吕滨 | 中国医学科学院 北京协和医学院 阜外心血管病医院放射科,北京 100037 | blu@vip.sina.com | | 韩磊 | 中国医学科学院 北京协和医学院 阜外心血管病医院放射科,北京 100037 | | | 白桦 | 中国医学科学院 北京协和医学院 阜外心血管病医院放射科,北京 100037 | | | 金敬琳 | 中国医学科学院 北京协和医学院 阜外心血管病医院放射科,北京 100037 | | | 徐仲英 | 中国医学科学院 北京协和医学院 阜外心血管病医院放射科,北京 100037 | | | 张戈军 | 中国医学科学院 北京协和医学院 阜外心血管病医院放射科,北京 100037 | | | 杜瑞宾 | 福建省立医院放射科,福建 福州 350001 | | | 蒋世良 | 中国医学科学院 北京协和医学院 阜外心血管病医院放射科,北京 100037 | | | 戴汝平 | 中国医学科学院 北京协和医学院 阜外心血管病医院放射科,北京 100037 | |
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| 中文摘要: |
| 目的 评价双源CT(DSCT)术前定量评估先天性心脏病肺动脉闭锁患者肺动脉及体肺侧支发育的价值。方法 20例肺动脉闭锁伴室间隔缺损(PA-VSD)患者同期接受DSCT、心血管造影(CA)和超声心动图检查(ECHO),以临床诊断为标准,对照分析3种检查对各种心脏畸形的检出率;着重对照同一患者肺动脉和体肺侧支相同位置的DSCT和CA测量值,并分别计算相应McGoon比值、肺动脉指数(PAI)和总体新生肺动脉指数(TNPAI)比值,对结果进行对照研究。结果 本组患者各种心脏畸形共55处,其中DSCT检出52处(94.55％),ECHO检出43处(78.18％),差异有统计学意义(P=0.012)。体肺侧支DSCT检出14例(共37支),CA检出13例(32支),差异无统计学意义(P=0.500)。肺动脉融合部DSCT检出16例,CA检出10例(P=0.047);DSCT和CA测量肺动脉、体肺侧支及膈水平胸主动脉直径的定量比较具有高度相关性(r＝0.95~0.98,P<0.01);相应McGoon比值(DSCT:1.18±0.60;CA:1.23±0.64)、PAI 和TNPAI 差异均无统计学意义(P均＞0.05)。结论 在无需获取压力等血流动力学资料的情况下,DSCT结合多普勒超声能够初步取代CA,成为肺动脉闭锁患者术前常规检查方式。 |
| 英文摘要: |
| Objective To observe the value of dual-source CT (DSCT) in quantitative measurement of pulmonary arteries and major aortopulmonary collateral vessels in the preoperative patients with pulmonary atresia with ventricular septal defect (PA-VSD). Method Twenty PA-VSD patients underwent DSCT, cardio-angiographic (CA) and echocardiography (ECHO) examination. Taking clinical diagnosis as the standard, results of DSCT, CA and ECHO on the detection of cardiac malformations, and measurement of pulmonary artery and collaterals, as well as the values of McGoon ratio, pulmonary arterial index (PAI) and total neopulmonary arterial index (TNPAI) were compared. Results In 20 patients, 52 (94.55%) of 55 cardiac malformations were visualized with DSCT, whereas 43 (78.18%) with ECHO (P=0.012). Fourteen patients with 37 pulmonary collateral vessels were detected with DSCT, and 13 patients (32 collaterals) with CA (P=0.500). Sixteen patients with confluence of pulmonary arteries were diagnosed with DSCT, whereas 10 patients with CA (P=0.047). Measurement of the diameters of pulmonary arteries, collateral vessels, and descending aorta at the level of diaphragma were correlated well between DSCT and CA (r=0.95—0.98, P<0.01). McGoon ratio (DSCT: 1.18±0.60; CA: 1.23±0.64), PAI (DSCT: mm2/m2; CA: mm2/m2) and TNPAI (DSCT: mm2/m2; CA: mm2/m2) had no statistical difference (all P>0.05). Conclusion DSCT has relative high value for evaluating and measuring pulmonary artery and aorto-pulmonary collateral vessels preoperatively in pulmonary artery atresia patients. Combined with CA, DSCT shows potential probability in replacement of CA for evaluating pulmonary artery atresia without obtaining hemodynamic information. |
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