超声心动图结合Flash CT对肺静脉畸形引流的诊断价值

发布时间：2018-02-10 01:11

本文关键词： 超声心动描记术体层摄影术 X线计算机肺静脉畸形引流诊断　出处：《中华医学超声杂志(电子版)》2016年06期 　论文类型：期刊论文

【摘要】：目的评价超声心动图结合Flash CT对肺静脉畸形引流(APVC)的诊断价值。方法 2011年9月至2015年5月郑州大学第一附属医院收治行心脏畸形矫治的各种不同类型的APVC患者71例。所有患者均经手术确诊。包括完全性肺静脉畸形引流(TAPVC)患者44例,部分性肺静脉畸形引流(PAPVC)患者27例。所有患者术前均行超声心动图与Flash CT检查。记录所有病例的CT剂量指数和剂量长度乘积(DLP),计算有效辐射剂量(ED)。采用Fisher确切概率法比较超声心动图与Flash CT对TAPVC/PAPVC分型、TAPVC/PAPVC合并畸形的诊断准确率差异。结果超声心动图与Flash CT对TAPVC分型的诊断准确率分别为86.4%(38/44)和97.7%(43/44),差异无统计学意义(P0.05)。超声心动图与Flash CT对TAPVC合并畸形的诊断准确率分别为100%(62/62)和95.2%(59/62),差异无统计学意义(P0.05)。Flash CT对PAPVC分型的诊断准确率为96.3%(26/27),高于超声心动图对PAPVC分型的诊断准确率74.1%(20/27),且差异有统计学意义(P0.05)。超声心动图对PAPVC合并畸形的诊断准确率为97.7%(43/44),高于Flash CT对PAPVC合并畸形的诊断准确率72.3%(34/44),且差异有统计学意义(P0.01)。71例APVC患者的辐射剂量:平均DLP为(13.5±3.9)m Gy·cm,平均ED值为(0.324±0.065)m Sv。结论超声心动图是诊断APVC传统的可靠方法,尤其对瓣膜病变、肺动脉压力及心功能可以做出全面评价。Flash CT大螺距扫描技术对心脏周围血管畸形的诊断具有独特的优势,在不影响诊断准确率的前提下,大大减少了射线的辐射剂量,尤其对于PAPVC患者,Flash CT诊断准确率要高于超声心动图,对超声心动图起到了很好的补充诊断作用。
[Abstract]:Objective to evaluate the diagnostic value of echocardiography combined with Flash CT in the diagnosis of anomalous pulmonary venous drainage. Methods from September 2011 to May 2015, different types of APVC patients with cardiac malformation were treated in the first affiliated Hospital of Zhengzhou University. All patients were confirmed by operation, including 44 patients with complete anomalous pulmonary venous drainage. Twenty-seven patients with partial anomalous pulmonary venous drainage were examined by echocardiography and Flash CT before operation. The dose index and dose length product of CT were recorded and the effective radiation dose was calculated by Fisher. Results the accuracy of echocardiography and Flash CT in the diagnosis of TAPVC was 86.4% and 97.7% 43 / 44 respectively. There was no significant difference between echocardiography and Flash CT in the diagnosis of TAPVC combined with TAPVC/PAPVC classification (P 0.05). Compared with Flash CT, the diagnostic accuracy of TAPVC combined with malformation was 100 / 62) and 95.2kW / 59 / 62respectively. There was no significant difference in the accuracy of diagnosis of PAPVC classification between P0.05U. Flash CT and Flash CT. The accuracy rate of diagnosis of PAPVC was 96.33.5% / 27%, which was higher than that of echocardiography in PAPVC classification (74.1% 20% 2727%), and the difference was statistically significant. The accuracy of echocardiography in the diagnosis of PAPVC complicated with malformation was 97.743 / 44, which was higher than that of Flash CT in diagnosis of PAPVC complicated with malformation. The difference was statistically significant (P 0.01). The radiation dose of 71 APVC patients was 13.5 卤3.9mGy 路cm, and the average Ed was 0.324 卤0.065mSv. Conclusion Echocardiography is a traditional and reliable method for the diagnosis of APVC. Especially for valvular disease, pulmonary artery pressure and cardiac function, the .Flash CT large-pitch scan technique has a unique advantage in the diagnosis of peri-cardiac vascular malformation, without affecting the diagnostic accuracy. The radiation dose is greatly reduced, especially for PAPVC patients, the diagnostic accuracy of flash CT is higher than that of echocardiography, which plays a good role in supplementary diagnosis of echocardiography.
【作者单位】：郑州大学第一附属医院超声科;郑州大学第一附属医院放射科;
【基金】：国家重点专科项目资助
【分类号】：R540.45;R654.2;R816.2

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