CT三维成像指导动脉导管未闭介入封堵术临床价值

发布时间：2018-06-16 04:23

本文选题：动脉导管未闭 + 介入治疗　；参考：《介入放射学杂志》2017年03期

【摘要】：目的评价256层螺旋CT三维成像在动脉导管未闭(PDA)介入封堵术中的临床应用价值。方法 40例经超声诊断PDA患儿,随机分为术中造影组(A组)和CT导引组(B组),每组20例。A组根据术中造影显示作PDA封堵,B组根据CT检查结果指导PDA封堵。术中心脏超声监测,评价疗效。结果 B组PDA三维成像形态与A组术中造影PDA形态高度一致,PDA最窄内径分别为(3.88±1.59)mm和(3.63±1.41)mm,长度分别为(6.10±1.06)mm和(6.82±0.74)mm,组间差异均无统计学意义(P0.05);手术时间分别为(17.33±5.81)min和(34.30±9.11)min,术中接受X线辐射剂量分别为(33.93±11.00)m Gy和(66.40±9.77)m Gy,组间差异均有显著统计学意义(P0.001)。但B组术前CT检查所接受辐射剂量为(119.79±29.45)m Gy,累加术中剂量后总剂量较A组显著增高。结论 256层螺旋CT增强扫描及三维成像可替代术中造影,准确获取PDA患儿解剖影像资料,指导介入封堵手术,同时有效减少穿刺动脉损伤,缩短手术时间。但辐射剂量是需要考虑的因素。
[Abstract]:Objective to evaluate the clinical value of 256-slice spiral CT 3-D imaging in interventional closure of patent ductus arteriosus (PDAs). Methods 40 children with PDA diagnosed by ultrasound were randomly divided into two groups: group A (n = 20) and group B (n = 20). Intraoperative echocardiographic monitoring was performed to evaluate the efficacy. Results the narrowest internal diameters of PDA in group B were 3.88 卤1.59)mm and 3.63 卤1.41mm. the lengths were 6.10 卤1.06)mm and 6.82 卤0.74mm, respectively. There was no significant difference between the two groups (P 0.05), the operative time was 17.33 卤5.81)min and 34.30 卤9.11min, respectively. The X-ray radiation doses were 33.93 卤11.00 mGy and 66.40 卤9.77 mGy, respectively, and there were significant differences between the two groups (P 0.001). But the radiation dose in group B was 119.79 卤29.45 mGy before CT scan, and the total dose was significantly higher than that in group A. Conclusion 256-slice spiral CT enhanced scanning and three-dimensional imaging can replace intraoperative angiography, accurately obtain anatomical image data of children with PDA, guide interventional closure surgery, reduce puncture artery injury and shorten operation time. But radiation dose is a factor to consider.
【作者单位】：金华市中心医院儿科;
【基金】：生殖遗传教育部重点实验室(浙江大学)开放基金(2012-RG/ND-0011)
【分类号】：R725.4;R816.92

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