64-MSCT在小儿复杂型先天性心脏病诊断中的应用
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摘要
目的
     探讨64排螺旋CT(64-muti detector spiral computed tomography,64-MSCT)在小儿复杂型先天性心脏病诊断中的价值。
     方法
     回顾性分析56例小儿复杂型先天性心脏病患者的完整资料。所有患儿均采用彩色多普勒超声和64-MSCT检查,并经常规心血管造影检查和/或手术证实。以手术、心血管造影结果为标准,对比彩色多普勒超声与64-MSCT对小儿复杂型先天性心脏病的诊断价值。
     结果56例复杂型先天性心脏病共164个畸形,其中64-MSCT诊断正确151处,诊断符合率为92.07%,彩色多普勒超声诊断正确130处,诊断符合率为79.27%。其中心内结构畸形实际存在59处,64-MSCT诊断正确49处,误诊8处,漏诊2处,诊断符合率为83.05%;彩色多普勒超声诊断正确57处,误诊2处,诊断符合率为96.61%。64-MSCT与彩色多普勒超声对诊断小儿复杂型先天性心脏病的心内结构畸形差异有统计学意义。56例患者实际存在心外畸形结构105处,64-MSCT诊断正确102处,误诊3处,诊断符合率为97.14%;彩色多普勒超声诊断正确73处,漏诊32处,诊断符合率为69.52%,两种检查方法对诊断心外结构畸形差异有统计学意义。
     结论
     64-MSCT对小儿复杂型先心病心外畸形结构的诊断符合率高于彩色多普勒超声,但是对心内畸形结构的诊断符合率略低于彩色多普勒超声。64-MSCT可以作为小儿复杂型先心病检查方法之一
Objective
     To investigate the diagnostic value of64-muti detector spiral computed tomography (64-MSCT)in children with complex congenital heart disease.
     Method
     The complex congenital heart disease data of56children were analyzed. All children with complex congenital heart disease underwent both64-MSCT and color Doppler ultrasonography. All patients were carried out angiocardiography and or surgical findings. According to the results of angiocardiography and or surgical findings,64-MSCT was compared with color Doppler ultrasonography.
     Result
     56children with complex congenital heart disease included164abnormal structures. in which64-MSCT diagnosis of right151.accurate diagnosis rate was92.07%, color Doppler ultrasound diagnosis of right130, diagnosis coincidence rate is79.27%.The intracardiac structural abnormalities were59places.49places were found by64-MSCT, but8were misdiagnosed and2were missed.57places were found by US, while2were mis diagnosed. The diagnosis coincidence rate of64-MSCT and color Doppler, ultrasonography for intracardiac malformation were83.05%and96.61%respectively.There were the obvious differences of the coincidence rates between the two methods. The extra cardiac structural abnormalities were105places,64-MSCT found102, misdiagnosed:3; color Doppler ultrasonography found73, misdiagnosed:32. The diagnosis coincidence rate of64-MSCT and color Doppler ultrasonography extra cardiac malformation was97.14%and69.52%, respectively. The coincidence rate of two examinations,64-MSCT and color Doppler ultrasonography, had obvious difference.
     Conclusion
     64-MSCT is superior to color Doppler ultrasonography in the detection of complex congenital heart disease in children, especially in detection of extra cardiac anomalies.64-MSCT should be used as a routine technique for the diagnosis imaging of children with complex congenital heart disease.
引文
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