超声心动图结合Flash CT对部分性肺静脉畸形引流的诊断价值

发布时间：2018-05-05 14:58

本文选题：肺静脉畸形 + 引流术　；参考：《中国医学影像学杂志》2015年05期

【摘要】：目的采用超声心动图结合Flash CT对部分性肺静脉畸形引流(PAPVC)患者行术前检查,并与手术结果对照,评价超声心动图结合Flash CT对PAPVC的诊断价值。资料与方法收集28例PAPVC患者,术前均行超声心动图及Flash CT大螺距扫描检查,观察PAPVC的类型、房间隔缺损的大小及合并其他畸形,并与手术结果进行对照。结果 28例患者中,超声确诊16例,提示可疑5例(其中4例证实为PAPVC,超声诊断正确;1例为肺静脉栓塞,超声误诊),漏诊6例,误诊1例;CT误诊1例;超声诊断准确率(71.4%,20/28)低于CT(96.4%,27/28)(P0.05);28例患者合并畸形共44处,超声确诊43处,漏诊1处;CT确诊34处,误诊2处,漏诊8处。超声诊断准确率(97.7%,43/44)高于CT(77.3%,34/44)(P0.05)。28例平均剂量长度乘积为(15.5±3.2)m Gy·cm,平均有效剂量为(0.354±0.058)m Sv。结论 Flash CT对PAPVC的诊断准确率较超声心动图高,但对合并心内畸形的诊断准确率低于超声心动图,而且超声可以对瓣膜病变、肺动脉压力及心功能做出全面评价,两者联合应用可以提高术前诊断准确率。
[Abstract]:Objective to evaluate the value of echocardiography combined with Flash CT in the diagnosis of PAPVC in patients with partial pulmonary venous deformity (PAPVC). Materials and methods Echocardiography and Flash CT large pitch scan were performed in 28 patients with PAPVC before operation. The types of PAPVC, the size of atrial septal defect and other malformations were observed and compared with the operative results. Results among 28 patients, 16 cases were diagnosed by ultrasound, 5 cases were suspected (4 cases were PAPVC, 1 case was pulmonary vein embolism, 6 cases were missed diagnosis, 1 case was misdiagnosed by CT). The accuracy of ultrasound diagnosis was 71.4% 20 / 28) lower than that of CT96.4% / 28% P0.05A total of 44 deformities, 43 cases of ultrasonic diagnosis, 34 cases of missed CT diagnosis, 2 cases of misdiagnosis and 8 cases of missed diagnosis. The average dose length product of 28 cases was 15.5 卤3.2 mGy 路cm, and the average effective dose was 0.354 卤0.058 mSv. Conclusion the diagnostic accuracy of Flash CT for PAPVC is higher than that of echocardiography, but the diagnostic accuracy of PAPVC is lower than that of echocardiography. Moreover, echocardiography can evaluate valvular disease, pulmonary artery pressure and cardiac function. The combination of the two can improve the accuracy of preoperative diagnosis.
【作者单位】：首都医科大学宣武医院超声科;郑州大学第一附属医院放射科;郑州大学第一附属医院超声科;
【分类号】：R540.45;R541.1;R816.2

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