王晓武, 张 本, 袁彬彬, 张卫达, 梅鲁刚. 双源64层CT与经胸超声心动图在诊断复杂先天性心脏病中的对照研究[J]. 心脏杂志, 2012, 24(3): 391-394.
    引用本文: 王晓武, 张 本, 袁彬彬, 张卫达, 梅鲁刚. 双源64层CT与经胸超声心动图在诊断复杂先天性心脏病中的对照研究[J]. 心脏杂志, 2012, 24(3): 391-394.
    Control study of dual-source computed tomography and ultrasound cardiography in diagnosis of complex congenital heart diseases[J]. Chinese Heart Journal, 2012, 24(3): 391-394.
    Citation: Control study of dual-source computed tomography and ultrasound cardiography in diagnosis of complex congenital heart diseases[J]. Chinese Heart Journal, 2012, 24(3): 391-394.

    双源64层CT与经胸超声心动图在诊断复杂先天性心脏病中的对照研究

    Control study of dual-source computed tomography and ultrasound cardiography in diagnosis of complex congenital heart diseases

    • 摘要: 目的:探讨双源64层CT(DSCT)在诊断复杂先天性心脏病(CCHD)中的应用价值,并与经胸超声心动图(TTE)进行对照研究。方法: 对186例CCHD患者同期行DSCT和TTE检查,以手术结果为标准,在心内异常解剖、心外大血管畸形的诊断上进行回顾性分析。结果: 手术证实心血管畸形共538处。DSCT检出506处,检出率为94.1%,TTE检出497处,检出率 为92.4%,两者差异无统计学意义,但两者联合检查检出529处,检出率达98.3%,明显高于单项检查(P<0.01)。其中,①心脏部分畸形:共 209处,DSCT检出190处,检出率为90.9%,TTE检出200处,检出率为 95.7%,两者差异无统计学意义;②心脏-大血管连接部分异常:共103 处,DSCT检出94 处,检出率为91.3%,TTE检出91处,检出率为88.4%,两者差异无统计学意义;③大血管部分畸形:共226处,DSCT检出222处,检出率为98.2%,TTE检出 206处,检出率为91.1%,两者差异有统计学意义(P<0.01),DSCT检出率显著高于TTE。结论: ①DSCT诊断心外大血管畸形的检出率高于TTE,对可疑并发大血管畸形的复杂先天性心脏病应作为常规检查手段;②DSCT与TTE联合应用可提高CCHD术前诊断的检出率。

       

      Abstract: AIM:To evaluate the clinical value of dual-source computed tomography (DSCT) in diagnosis of complex congenital heart diseases (CCHD) using a control study with transthoracic ultrasound cardiography (UCG). METHODS: DSCT and UCG were performed in 186 patients with CCHD and their diagnosis of cardiovascular anomalies was later surgically confirmed and compared. RESULTS: In all patients, 538 cardiovascular anomalies were confirmed. Accuracy of DSCT and UCG was 94.1% and 92.4%, respectively, and diagnostic accuracy showed no statistical difference (P=0.281). Of the 209 confirmed intracardiac anomalies, DSCT detected 190 (90.9%) and UCG detected 200 (95.7%), with no statistical difference in the diagnostic accuracy rate (P=0.052). Of the 103 confirmed heart-vessel conjunction anomalies, DSCT detected 94 (91.3%) and UCG detected 91 (88.4%), also with no statistical difference in the diagnostic accuracy rate (P=0.629). Of the 226 confirmed great vessel anomalies, statistical difference was observed in the diagnostic accuracy between the 222 (98.2%) detected by DSCT and the 206(91.1%) detected by UCG (P<0.01), showing that DSCT was superior to UCG. CONCLUSION: DSCT is superior to transthoracic UCG in the diagnosis of great vessel anomalies and can be used as one of the non-invasive conventional preoperative detection methods for CCHD. Use of DSCT combined with UCG can improve the diagnostic accuracy of CCHD.

       

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