MSCT低剂量血管成像技术在儿童先天性主动脉畸形诊断中的应用

发布时间：2018-11-26 16:43

【摘要】：【目的】探讨多层螺旋CT(MSCT)低剂量血管成像技术在儿童先天性主动脉畸形诊断中的应用价值。【方法】对84例采用64层螺旋CT低剂量血管成像技术诊断的儿童先天性主动脉畸形病例作回顾性分析,并与超声心动图(TTE)及手术、心血管造影结果进行比较分析,其中63例经手术确诊、21例经心血管造影证实。术后CT复查26例。【结果】根据患儿体质量分别采取80、100及120 k V管电压,其例数分别为32、38及14,管电流自动调节(在35~80 m A范围变动),X线辐射剂量(m Gy)比预设常规扫描模式减低幅度为20%~50%不等。所有病例图像均达到诊断标准。全组84例中,包括双主动脉弓3例、主动脉弓褶曲10例、主动脉缩窄18例、主动脉弓离断7例、单纯动脉导管未闭41例、共同动脉干3例及主-肺动脉窗2例,其中CT诊断准确率97.6%(82/84),TTE诊断准确率83.3%(70/84)。84例中,合并其他畸形共37处,其中CT发现32处,TTE发现33处。术后CT复查中,发现术后并发症7例。【结论】64层螺旋CT低剂量血管成像能有效降低辐射剂量的同时,可以清晰客观地显示儿童主动脉畸形及其合并畸形的病理解剖,与超声心动图互补,能明显提高主动脉畸形的检出率及诊断准确率,对主动脉畸形的术前诊断及术后疗效观察有重要价值,可基本代替血管造影检查。
[Abstract]:[objective] to evaluate the value of multislice spiral CT (MSCT) low dose angiography in the diagnosis of congenital aortic malformation in children. [methods] Eighty-four children with 64-slice spiral CT low-dose angiography were studied. Children with congenital aortic malformation were retrospectively analyzed. The results of echocardiography, (TTE), operation and angiocardiography were compared. Among them, 63 cases were confirmed by operation and 21 cases by cardiac angiography. [results] according to the body mass of the patient, the voltage of 80100 and 120kV tube was taken, the cases were 32, 38 and 14, respectively. The current of the tube was adjusted automatically (in the range of 3580mA). The X-ray radiation dose of (m Gy) was decreased by 20 ~ 50% compared with the conventional scanning mode. The images of all cases met the diagnostic criteria. Among the 84 cases, there were 3 cases of double aortic arch, 10 cases of aortic arch fold, 18 cases of aortic coarctation, 7 cases of aortic arch dissection, 41 cases of patent ductus arteriosus, 3 cases of common artery trunk and 2 cases of aorta window. The diagnostic accuracy of CT was 97.6% (82 / 84), TTE, 83.3%, 70 / 84). Among 84 cases, 37 were associated with other deformities, of which 32 were found by CT and 33 by TTE. After CT, 7 cases of postoperative complications were found. [conclusion] 64-slice spiral CT low dose angiography can effectively reduce the radiation dose, and can clearly and objectively display the pathological anatomy of aortic malformation and associated malformation in children. Complementation with echocardiography can significantly improve the detection rate and diagnostic accuracy of aortic malformation. It has important value in preoperative diagnosis and postoperative observation of aortic malformation and can be used as a substitute for angiography.
【作者单位】：中山大学附属第一医院放射科;
【分类号】：R725.4;R816.92

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