顺序分段分析在MSCT诊断全心畸形类先心病中的应用研究

发布时间：2018-02-14 03:18

  本文关键词： 64层螺旋CT 顺序分段分析 全心畸形 先天性心脏病 超声心　出处：《广西医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的通过应用顺序分段分析法分析全心畸形类先天性心脏病的64层螺旋CT图像,探讨顺序分段分析法在MSCT诊断此类先心病中的临床应用价值。 方法分析98例行64层螺旋CT和超声心动图检查并经手术证实为全心畸形类先天性心脏病患者的资料。其中男63例,女35例,年龄1个月—47岁,平均年龄10.07±9.78岁；所有病例均经GE lightspeed VCT 64层螺旋CT行平扫及团注增强扫描,增强时使用团注造影剂追踪技术,获取图像传入ADW4.4后处理工作站,使用多平面重组(MPR)、最大密度投影(MIP)和容积再现(VR)等重建方法进行分析,观察的心脏大血管位置、形态改变及合并的心血管畸形征象,按顺序分段分析诊断法进行分段分析,列出相应节段的形态学畸形改变然后汇集统计,最后与相应超声心动图检查、手术结果进行综合比较。 结果(1)64层螺旋CT对全心畸形类先天性心脏病的形态学畸形的显示：心房段畸形66处,64层CT确诊44处,检出率66.7%；心室段畸形179处,CT确诊178处,检出率99.4%；房室连接段畸形18处,64层CT确诊18处,检出率100%；大动脉段畸形101处,64层CT确诊94处,检出率93.1%；心室大动脉连接段畸形148处,64层CT确诊133处,检出率89.9%；心脏位置异常13处,64层CT确诊13处,检出率100%。(2)64层螺旋CT与彩色超声心动图在心房段、心室段、房室连接段、心室大动脉连接段、心脏位置异常方面畸形的诊断检出率比较,差异无统计学意义；在大动脉段畸形方面与超声心动图比较有统计学意义,对大动脉段畸形的检出率明显优于超声。(3)64层螺旋CT对房、室间隔缺损大小等计量指标的测量值与手术结果、超声诊断结果分别比较,差异无统计学意义。 结论(1)64层螺旋CT扫描速度快,时间、空间、密度分辨率高,达到各向同性,凭借各种后处理技术重组的图像能全面、准确、直观显示全心畸形类先天性心脏病各种心血管结构异常,因此是先天性心脏病的一项重要无创检查技术。(2)64层螺旋CT血管造影对全心类心血管畸形心房、心室、房室连接、心室大动脉连接段以及心脏位置异常的检出率与彩色超声心动图比较无明显优势,而对大动脉段的畸形检出率优于超声心动图；无法显示瓣膜功能改变；64层螺旋CT与超声心动图互相补充、联合诊断可提高对先心病心血管结构异常的诊断准确率,并了解血流动力学改变。(3)64层螺旋CT心脏检查藉由多种后处理技术,配合使用顺序分段分析可全面、正确了解先心病各种心血管异常的形态学改变,对临床治疗方案制定提供丰富、直观的影像学信息。
[Abstract]:Objective to analyze the 64 slice spiral CT images of congenital heart disease of whole heart by sequential segmental analysis, and to explore the clinical value of sequential segmental analysis in diagnosing congenital heart disease by MSCT.
Methods 98 cases with 64 slice spiral CT and echocardiography and confirmed by surgery for heart malformation of congenital heart disease patients. There were 63 male and 35 female patients, aged from 1 months to 47 years of age, the average age of 10.07 + 9.78 years; all cases were confirmed by GE Lightspeed VCT 64 slice spiral CT plain and bolus enhancement scan, enhanced using bolus tracking technology, obtaining image into ADW4.4 postprocessing workstation, using multi planar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR) reconstruction method, observation of cardiac vascular position, cardiovascular malformation signs form change and merge, piecewise analysis analyzing diagnosis method in order to list the morphological deformity of the corresponding segments and then aggregated statistics, and finally the corresponding echocardiography and surgical results were compared.
Results (1) morphology of 64 slice spiral CT with heart malformations of congenital heart disease deformity showed that atrial section 66 deformities, 64 CT were 44, the detection rate of 66.7%; ventricular segment 179 deformities, CT was 178, the detection rate of 99.4%; 18 deformities with atrioventricular segment, 64 layer CT with 18, the detection rate of 100%; the large artery malformation 101, 64 layer CT diagnosed 94, the detection rate of 93.1%; ventricular arterial connection section 148 deformities, 64 CT were 133, the detection rate of 89.9%; cardoanastrophe 13, 64 layer CT were 13, the detection rate of 100%. (2) 64 slice spiral CT and color Doppler echocardiography in atrial, ventricular, atrioventricular junction, ventricular arterial connection, heart abnormalities to diagnose abnormalities, no significant difference; in large artery segment deformity and echocardiography was statistically significant, the artery malformation the detection rate was significantly It is better than ultrasound. (3) there is no significant difference between the 64 slice spiral CT in measuring the size of atrial septal defect and the results of operation and ultrasonic diagnosis.
缁撹��(1)64灞傝灪鏃婥T鎵�鎻忛�熷害蹇，

本文编号：1509754