多排螺旋CT在婴幼儿法洛四联症诊断中的价值
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摘要
目的
法洛四联症(Tetralogy of Fallot,TOF)是紫绀型先天性心脏病(先心病)中最常见的一种,占紫绀型先心病的80%,占所有先心病的10%,是复杂先心病的50%-90%。对于法洛四联症的影像学诊断方法主要有经胸壁超声心动图(Transthoracic Echocardiography,TTE)、心血管造影(Angiocardiography,ACG)、电子束CT(Electron Beam Computed Tomography,EBCT)、核磁共振成像(Magnetic ResonanceImaging,MRI)及多排螺旋CT心血管造影(Multislice Spiral Computed TomographyAngiography,MSCTA)等。ACG被认为是诊断先天性心脏病的“金标准”。MSCTA是一种安全、无创、快速的先心病诊断技术。目前关于MSCTA对法洛四联症的定性诊断价值的研究的国内外文献较多,但对于MSCTA对法洛四联症的术前定量诊断价值探讨较少。本文通过将MSCTA和TTE检查所得的法洛四联症患者的具体数据进行统计学分析,研究MSCTA对法洛四联症的术前定量诊断价值;旨在为法洛四联症术前检查提供更加方便而准确的影像学诊断方法。
材料和方法
1.研究对象
实验组:2007年7月至2008年11月在郑州大学第三附属医院术前进行MSCT心脏动态增强造影检查和TTE检查,并经手术中证实为法洛四联症的0-3岁患儿病例共65例。
对照组:本院同时期相同年龄段,术前进行MSCT心脏动态增强造影检查术后证实为单纯室间隔缺损的患儿共54例。
2.方法
利用GE Lightspeed 16排螺旋CT对患儿进行MSCTA检查,所采集到的图像在ADW4.2工作站上利用各种重建技术分析、诊断、测量,并计算McGoon指数和Nakata指数。
利用GE Vivid 7 PRO型彩超对患儿进行TTE检查,测量室间隔缺损宽度、肺动脉各段内径、降主动脉内径,并计算McGoon指数和Nakata指数。
3.统计学检验
应用SPSS16.0软件对所得数据计算均数、标准差及进行单因素方差分析并对MSCTA检查和TTE检查对于心外大血管的显示情况进行x~2检验。采用α=0.05检验标准。
结果
1.MSCT和TTE对于相同法洛四联症患者不同部位内径的测量所得的值无统计学差别(P＞0.05)。
2.MSCT对于法洛四联症患儿与单纯室间隔缺损患儿肺动脉各段内径的测量值有统计学差别(P＜0.05)。
3.MSCT和TTE在显示左右肺动脉近端时无统计学意义(P＞0.05),而在显示左右肺动脉远端时有统计学差别(P＜0.05)。
结论
1.MSCTA检查能够很好的对法洛四联症做出定性诊断,还能够对法洛四联症做出准确的定量诊断,对临床手术的选择及预后的评估有重要的意义。
2.MSCTA检查作为一种安全、无创、快速、准确的先心病诊断方法,能够基本代替TTE检查。并且对于肺动脉等心外大血管畸形的诊断要优于TTE检查。
Objectives
Tetralogy of Fallot (TOF) is one of the most common Cyanotic Congenital Heart Disease (CHD). It holds about 80% of Cyanotic Congenital Heart Disease,about 10% of all kinds of Congenital Heart Disease, about 50%-90% of complex Congenital Heart Disease, The diagnostic methods we have now including TTE (Transthoracic Echocardiography),ACG(Angiocardiography),EBCT(Electron Beam Computed Tomography),MRI (Magnetic Resonance Imaging) and MSCTA (Multislice Spiral Computed Tomography Angiography) ,et al. ACG is normally considered as the gold standard method of TOF. MSCTA as a diagnostic method of CHD has many advantages such as safe, noninvasive and fast. Nowadays there have some literatures about the quality diagnostic value of MSCTA, but less thesis about the quantity diagnostic value of MSCTA. My thesis paid attention to the quantity diagnostic value of MSCTA before surgery. Analyzed the patients' status of TOF which got by both MSCTA and TTE, in order to offer a quick and accuracy diagnostic method for TOF.
Materials and Methods
1. Object
Experimental group: 65 cases 0-3 years old neonates and infants with Tetralogy of Fallot whom was certified by surgery and had examined by MSCTA and TTE in The Third Affiliated Hospital of Zhengzhou University between July 2007 and November 2008.
Control group: 54 cases 0-3 years old neonates and infants with Ventricular Septal Defect whom was certified by surgery and had examined by MSCTA in The Third Affiliated Hospital of Zhengzhou University between July 2007 and November 2008.
2. Method
Examine the patient with MSCTA by GE Lightspeed 16 slices spiral CT. Then analyze, diagnose and measure images in workstation ADW 4.2 by all kinds of reformation methods and calculate McGoon Index and Nakata Index.
Examine the patient with TTE by GE Vivid 7 PRO color Doppler ultrasound instrument. Measure the width of VSD, the inner diameter of pulmonary and descending aorta. Calculate McGoon Index and Nakata Index.
3. Statistical analysis
SPSS16.0 statistical packages on the measurement data for statistical analysis, using mean, standard deviation, single-factor analysis of variance and X~2 text (α=0.05).
Results
1. The inner diameters in different parts of patients with TOF measured by MSCT or TTE have no statistical difference (P>0.05).
2. The inner diameters of different parts of pulmonary artery of patients with TOF or VSD have statistical difference (P<0.05).
3. There is no statistical difference in display proximal end of pulmonary artery between MSCT and TTE(P>0.05). There has statistical difference in display distal end of pulmonary artery between MSCT and TTE (P<0.05).
Conclusions
1. MSCTA can not only make good diagnostic of qualitation but also make accurate diagnostic of quantitation, it has great mean to the choice of surgery and the evaluation of prognosis.
2. MSCTA is a diagnostic method of CHD with safe, noninvasive, fast and accurate. It can almost instead of TTE and it is better than TTE in display extra-cardiac arteries like pulmonary artery.
法洛四联症(Tetralogy of Fallot,TOF)是紫绀型先天性心脏病(先心病)中最常见的一种,占紫绀型先心病的80%,占所有先心病的10%,是复杂先心病的50%-90%。对于法洛四联症的影像学诊断方法主要有经胸壁超声心动图(Transthoracic Echocardiography,TTE)、心血管造影(Angiocardiography,ACG)、电子束CT(Electron Beam Computed Tomography,EBCT)、核磁共振成像(Magnetic ResonanceImaging,MRI)及多排螺旋CT心血管造影(Multislice Spiral Computed TomographyAngiography,MSCTA)等。ACG被认为是诊断先天性心脏病的“金标准”。MSCTA是一种安全、无创、快速的先心病诊断技术。目前关于MSCTA对法洛四联症的定性诊断价值的研究的国内外文献较多,但对于MSCTA对法洛四联症的术前定量诊断价值探讨较少。本文通过将MSCTA和TTE检查所得的法洛四联症患者的具体数据进行统计学分析,研究MSCTA对法洛四联症的术前定量诊断价值;旨在为法洛四联症术前检查提供更加方便而准确的影像学诊断方法。
材料和方法
1.研究对象
实验组:2007年7月至2008年11月在郑州大学第三附属医院术前进行MSCT心脏动态增强造影检查和TTE检查,并经手术中证实为法洛四联症的0-3岁患儿病例共65例。
对照组:本院同时期相同年龄段,术前进行MSCT心脏动态增强造影检查术后证实为单纯室间隔缺损的患儿共54例。
2.方法
利用GE Lightspeed 16排螺旋CT对患儿进行MSCTA检查,所采集到的图像在ADW4.2工作站上利用各种重建技术分析、诊断、测量,并计算McGoon指数和Nakata指数。
利用GE Vivid 7 PRO型彩超对患儿进行TTE检查,测量室间隔缺损宽度、肺动脉各段内径、降主动脉内径,并计算McGoon指数和Nakata指数。
3.统计学检验
应用SPSS16.0软件对所得数据计算均数、标准差及进行单因素方差分析并对MSCTA检查和TTE检查对于心外大血管的显示情况进行x~2检验。采用α=0.05检验标准。
结果
1.MSCT和TTE对于相同法洛四联症患者不同部位内径的测量所得的值无统计学差别(P＞0.05)。
2.MSCT对于法洛四联症患儿与单纯室间隔缺损患儿肺动脉各段内径的测量值有统计学差别(P＜0.05)。
3.MSCT和TTE在显示左右肺动脉近端时无统计学意义(P＞0.05),而在显示左右肺动脉远端时有统计学差别(P＜0.05)。
结论
1.MSCTA检查能够很好的对法洛四联症做出定性诊断,还能够对法洛四联症做出准确的定量诊断,对临床手术的选择及预后的评估有重要的意义。
2.MSCTA检查作为一种安全、无创、快速、准确的先心病诊断方法,能够基本代替TTE检查。并且对于肺动脉等心外大血管畸形的诊断要优于TTE检查。
Objectives
Tetralogy of Fallot (TOF) is one of the most common Cyanotic Congenital Heart Disease (CHD). It holds about 80% of Cyanotic Congenital Heart Disease,about 10% of all kinds of Congenital Heart Disease, about 50%-90% of complex Congenital Heart Disease, The diagnostic methods we have now including TTE (Transthoracic Echocardiography),ACG(Angiocardiography),EBCT(Electron Beam Computed Tomography),MRI (Magnetic Resonance Imaging) and MSCTA (Multislice Spiral Computed Tomography Angiography) ,et al. ACG is normally considered as the gold standard method of TOF. MSCTA as a diagnostic method of CHD has many advantages such as safe, noninvasive and fast. Nowadays there have some literatures about the quality diagnostic value of MSCTA, but less thesis about the quantity diagnostic value of MSCTA. My thesis paid attention to the quantity diagnostic value of MSCTA before surgery. Analyzed the patients' status of TOF which got by both MSCTA and TTE, in order to offer a quick and accuracy diagnostic method for TOF.
Materials and Methods
1. Object
Experimental group: 65 cases 0-3 years old neonates and infants with Tetralogy of Fallot whom was certified by surgery and had examined by MSCTA and TTE in The Third Affiliated Hospital of Zhengzhou University between July 2007 and November 2008.
Control group: 54 cases 0-3 years old neonates and infants with Ventricular Septal Defect whom was certified by surgery and had examined by MSCTA in The Third Affiliated Hospital of Zhengzhou University between July 2007 and November 2008.
2. Method
Examine the patient with MSCTA by GE Lightspeed 16 slices spiral CT. Then analyze, diagnose and measure images in workstation ADW 4.2 by all kinds of reformation methods and calculate McGoon Index and Nakata Index.
Examine the patient with TTE by GE Vivid 7 PRO color Doppler ultrasound instrument. Measure the width of VSD, the inner diameter of pulmonary and descending aorta. Calculate McGoon Index and Nakata Index.
3. Statistical analysis
SPSS16.0 statistical packages on the measurement data for statistical analysis, using mean, standard deviation, single-factor analysis of variance and X~2 text (α=0.05).
Results
1. The inner diameters in different parts of patients with TOF measured by MSCT or TTE have no statistical difference (P>0.05).
2. The inner diameters of different parts of pulmonary artery of patients with TOF or VSD have statistical difference (P<0.05).
3. There is no statistical difference in display proximal end of pulmonary artery between MSCT and TTE(P>0.05). There has statistical difference in display distal end of pulmonary artery between MSCT and TTE (P<0.05).
Conclusions
1. MSCTA can not only make good diagnostic of qualitation but also make accurate diagnostic of quantitation, it has great mean to the choice of surgery and the evaluation of prognosis.
2. MSCTA is a diagnostic method of CHD with safe, noninvasive, fast and accurate. It can almost instead of TTE and it is better than TTE in display extra-cardiac arteries like pulmonary artery.
引文
1.汪曾炜,刘维永,张宝仁,心脏外科学[M].北京:人民军医出版社,2003,1:878-933.
2.刘迎龙.法洛四联症.继续医学教育.2006,20(18):7-11.
3.刘锦纷,孙彦隽,苏肇伉,等.2186例小儿法洛氏四联症外科治疗析[J].上海第二医科大学学报,2004,24(3):165-168.
4.Rhodes J,O'Bfien S,Patel H,et al.Palliative balloon pulmonary valvuloplasty in tetralogy of fallot:echocardiographic predictors of successful outcome[J].Invasive Cardiol,2000,12(9):448-451.
5.高文根,张仁福,汪曾炜,等.婴儿法洛氏四联症外科治疗的危险因素分析[J].中华小儿外科杂志,2004,25(5):417-419.
6.杨思源,主编.小儿心脏病学.人民卫生出版社,2000,183-184.
7.Kawano T,lahii M,Takagi J,et al.Three-dimensional helical computed tomographic angiography in neonates and infants with complex congenital heart disease[J].Am Heart J,2000,139(2):654-660.
8.Haramati LB,Gickstein JS,Issenberg HJ,et al.MR imaging and CT vascular anomalies and connections in patients with congenital heart disease:significance in surgical planning[J].Radiographics,2002,22(4):337-341.
9.Wolfson BJ.Radiologic interpretation of congenital heart disease[J].Clin Perinatol,2001,28(1):71-74.
10.朱铭,李玉华,钟玉敏.增强MR血管造影在儿童先天性心脏病诊断中的应用[J].中华放射学杂志,2002,36(2):123.
11.朱杰明.儿童CT诊断学[M].上海科技出版社,2003,3-13.
12.Kerkhoff,Gert,Schmermund,Axel,Moehlenkamp,Stephan,et al.Noninvasive plaque imaging using contrast-enhanced cardiac computed tomomgraphy[J].Herz,2003,28(6):521-529.
13.Shiraishi I,Sorantin E,Groell R,et al.Helical CT angiography in obstructed total anomalous pulmonary venous drainge[J].AJR,2000,175(4):1041-1045.
14.黄美萍,梁长虹,曾辉,等.小儿先天性心脏病肺动脉发育多层螺旋CT研究[J].放射学实践,2004,19(8):608-611.
15.Knez A,Becker CR,Leber A,et al.Usefulness of multislice spiral computed tomography angiography for determination of coronary artery disease[J].Am J Cardiol,2001,88(10):1191-1194.
16.Nieman K,Rensing BJ,Van Geuns RJ,et al.Usefulness of multislice spiral computed tomography angiography for determination of coronary artery disease [J].Am J Cardiol,2002,89(8):913-918.
17.Rhodes J,O'Brien S,Patel H,et al.Palliative balloon pulmonary valvuloplasty in tetralogy of fallot:echocardiographic predictors of successful outcome[J].Invasive Cardiol,2000,12(9):448-451.
18.王荣品,先正元,杨明放,等.多层螺旋CT对复杂型先天性心脏病的诊断价值[J].临床放射学杂志,2007,26(4):341-346.
19.龚洪翰,蒋海清,韩萍,等.多层螺旋CT后处理技术临床应用[M].南昌:江西科学技术出版社,2004,193-196.
20.Bean M J,Pannu H,Fisheman EK.Three-Dimenasional computed tomographic imaging of complex congenital cardiovascular abnonmailties[J].Comput Assist Tomogr,2005,29:721.
21.Gilkeson RC,Ciancibello L,Zahka K.Multidetector CT evaluation of congenital heart disease in pediatric and adult patients.AJR,2003,180:973.
22.Fontan F,Fernandez G,Costa F,et al.The size of pulmonary arteries and the results of the Fontan operation.J Thorac Cardiovasc Surg,1989,98(4):711-724.
23.胡咏梅,等.人体体表面积实测值与Stevenson公式计算值比较.新乡医学院学报,1996,16(3):228-230.
24.Jonson H,Lvert T,Jonasson R,et al.Work capacity and central hemodynamic thirteen to twenty-six year after repair of tetralogy of Fallot[J].Thorac Cardiovasc Surg,1995,110(3):416-426.
25.Okita Y,Miki S,Ueda Y,et al.Early and lateresults of repair of tetralogy of Fallot with subarterial ventricular septal defect[J].Thorac Cardiovasc Surg,1995,109(1):180-185.
26.Frank L,Rita D,Andrea M,et al.Impact of blunted pulmonary venous flow on the outcome of patients with left ventricular systolic dysfunction secondary to either ischemic or idiopathic dilated cardiomyopathy.Am J Cardiol,2000,85(6):1455-1460.
27.Reza Sabri M,Sholler G,Hawker R,et al.Branch pulmonary artery growth after Blalock-Taussing shunts in tetralogy of fallot and pulmonary atresia with ventricular septal defect:A Retrospective,Echocardiographic study[J].Pediatr Cardiol,1999,20(5):358-363.
28.Nakata S,Imai Y,Takanashi Y,et al.A new method for the quantitative standardization of cross-sectional areas of the pulmonary arteries in congenital heart diseases with decreased pulmonary blood flow[J].Thorac Cardiovasc Surg,1984,88:610-619
29.李向民,周旭辉,杨有优,等.电子束CT诊断婴幼儿先天性心脏病并与超声心动图及手术对照.中华放射杂志,2003,37:644.
30.Funabashi N,Rubin GD.Qualitative blood flow differentiation-de-picition of a left to right cardiac shunt across aventricular septal defect using Electron-beam computed tomography.Japan Cite[J].2000,64:901.
31.Boechat MI,Ratib O,Williams PL,et al.Cardiac MR imaging and MR angiography for assessment of complex tetralogy of Fallot and pulmonary atresia.Radiaographica,2005,25:1535.
32.Boxt LM.Magnetic resonance and computed tomographic evaluation of congenital heart disease[J].Magn Resort Imaging,2004,19:827.
33.Rebergen,Sidney A.,de Roos,Albert,et al.Congenital heart disease.Evaluation of anatomy and function by MRI[J].Herz,2000,25(4):365-383.
34.Sklansky M.Advances in Fetal Cardiac Imaging.Pedistr Cardiol,2004,25:307.
35.Shiraishi I,Yamagishi M,Iwasaki N,et al.Helical computed tomographic angiography in obstructed total anomalous pulmonary venous drainage[J].Ann Thorac Surg,2001,71(5):1690-1692.
36.Masiello P,Santoro G,Franzesi E,et al.Aortic pseudo coarctation:spiral volumetric computed tomography imaging[J].Ann Thorac Surg,1999,68(4): 1421.
37.Achenbach S,Ulzheimer S,Baum U,et al.Noninvasive coronary angiography by retrospectively ECG gated multislise spiral CT[J].Circulation,2000,102(23):2823-2828.
38.Schaffier Gj,Sorantin E,Groell R,et al.Helical CT angiography with maximum intensity projection in the assessment of aortic coarction after surgery.AJR,2000,175:1041-1045.
39.Wesra S J,Hill JA,Alejos JC,et al.Three-dimensional helical CT of pulmonary arteries in infants and children with congenital heart disease[J].AJR,1999,173(1):109-115.
40.Hemininger BM,Molina PL,Egain TM,et al.Assesament of realtime 3D visualization for cardiothoracic diagnostic evaluation and surgery planning.Journal of Digital Imaging,2005,18(2):145.
41.Klingerbeck R,Schaller S,Fhlor T,et al.Subsecond multislice computed tomography,basis and applications,Eur[J].Radiol,1999,31:110-124.
42.Carrascosa PM,Capunay CM,Parodj JC,et al.General utilities of multislice tomography in the cardiac field.Herz,2003,28(1):44-51.
43.Gilkeson RC,Ciancibello L,Kenneth Z.Multidetector CT evaluation of congenital heart disease in pediatric and adult patients.AJR,2003,180:973-980.
44.Goo HW,Ko FK,Kim YH,et al.CT of congenital heart disease:Normal anatomy and typical pathologic conditions.Radiographics,2003,23:S147-S165.
45.Siegel MJ.Multiplanar and Three2dimensional Multi2detector Row CT of Thoracic Vessels and Airways in t he Pediatric Population[J].Radiology,2003,229(3):641-650.
46.黄美萍,梁长虹,曾辉,等.多层螺旋CT在小儿复杂先天性心脏病诊断中的应用.中华放射学杂志,2004,38(7):726.
47.Nieman K,Rensing BJ,Van Geuns RJ,et al.Non-invasive coronary angiography with multislice spiral computed tomography:impact of heart rate[J].Heart.2002,88(5):470-474.
48.Kawano T,Ishii M,Takagi J,et al.Three-dimensional helical computed tomographic angiography in neonates and infants[J].Am J Roentgend,2000,175(5):1381-1386.
49.Hall EJ.Lessons We Have Learned from Our Children:Cancer Risks from Diagnostic Radiology[J].Pediatr Radiol,2002,32(10):700-706.
50.孙爱敏,朱铭,钟玉敏,等.16层螺旋CT在先天性心脏病诊断中的应用.放射学实践.2007,22(3):252-255.
1.Samyn MM,A review of the complementary information available with cardiac magnetic resonance imaging and multi2slice computed tomography(CT) during the study of congenital heart disease.Inter[J].Cardiovas Image,2004,20:569.
2.陶中良,张玉玲,孙向东,等.常见先天性心脏病的诊断与手术治疗.河南外科学杂志,2003,9:4.
3.周爱卿,主编.心导管术2先天性心脏病诊断与治疗.济南:山东科学技术出版社,1997,160.
4.高云华.先天性心脏病的超声诊断方法及进展.临床超声医学志,2002,4:188.
5.汪曾炜,刘维永,张宝仁,心脏外科学[M].北京:人民军医出版社,2003,1:878-933.
6.刘迎龙.法洛四联症.继续医学教育.2006,20(18):7-11.
7.朱铭,李玉华,钟玉敏.增强MR血管造影在儿童先天性心脏病诊断中的应用[J].中华放射学杂志,2002,36(2):123.
8.朱杰明.儿童CT诊断学[M].上海:上海科技出版社,2003,3-13.
9.朱铭.儿童先天性心脏病影像诊断.中国实用儿科学杂志.2004,19(3):186-188.
10.Sokol I,Vineelj J.Kifin M.Echocardiographic features of adult Tetralogy of Fallot with natural palliative correction by patent ductus arteriosus[J].2003,44(2):234-238.
11.Sklansky M.Advances in Fetal Cardiac Imaging.Pedistr Cardiol,2004,25:307.
12.Kerkhoff,Gert,Schmermund,Axel,Moehlenkamp,Stephan,et al.Noninvasive plaque imaging using contrast-enhanced cardiac computed tomomgraphy[J].Herz,2003,28(6):521-529.
13.Shiraishi I,Sorantin E,Groell R,et al.Helical CT angiography in obstructed total anomalous pulmonary venous drainge[J].AJR,2000,175(4):1041-1045.
14.Shiraishi I,yamagishi M,Iwasaki N,et al.Three-dimensional helical computed tomographic angiography in obstructed total anomalous pulmonary venous drainage[J].Ann Thorac Surg,2001,71(7):1690-1692.
15.金泽宁,谢若兰,戴汝平,等.先天性心脏病心肺动脉发育情况的电子束CT 与心血管造影对照研究[J].中华放射学杂志,1998,32(8):515-518.
16.Boechat MI,Ratib O,Williams PL,et al.Cardiac MR imaging and MR angiography for assessment of complex tetralogy of Fallot and pulmonary atresia.Radiaographica,2005,25:1535.
17.Boxt LM.Magnetic resonance and computed tomographic evaluation of congenital heart disease[J].Magn Reson Imaging,2004,19:827.
18.Rebergen,Sidney A.,de Roos,Albert,et al.Congenital heart disease.Evaluation of anatomy and function by MRI[J].Herz,2000,25(4):365-383.
19.李向民,周旭辉,杨有优,等.电子束CT诊断婴幼儿先天性心脏病并与超声心动图及手术对照.中华放射杂志,2003,37:644.
20.Funabashi N,Rubin GD.Qualitative blood flow differentiation-de-picition of a left to right cardiac shunt across aventricular septal defect using Electron-beam computed tomography.Japan Cire[J].2000,64:901.
21.Samyn MM,A review of the complementary information available with cardiac magnetic resonance imaging and multi-slice computed tomography(CT)during the study of congenital heart disease[J].Inter J Cardiovas Imag,2004,20:569.
22.刘锦纷,孙彦隽,苏肇伉,等.2186例小儿法洛氏四联症外科治疗分析[J].上海第二医科大学学报,2004,24(3):165-168.
23.高文根,张仁福,汪曾炜,等.婴儿法洛氏四联症外科治疗的危险因素分析[J].中华小儿外科杂志.2004,25(5):417-41.
24.Borowski A,Ghodsizad A,Litmathe J,et al.Severe pulmonary.Regu tation late after total repair of tetralogy of Fallot:surgical considerations[J].Pediatr Cardiol,2004,25(2):466-471.
25.Xiao TT,Chen SB,Zhang YQ,et al.Exploration of methods for evaluating the development of pulmonary arteries in tetralogy of Fallot[J].Cardiovasc Pulmonary Dis(Chinese),2002,21(1):26-28.
26.Nakata S,Imai Y,Takanashi Y,et al.A new method for the quantitative standardization of cross-sectional areas of the pulmonary arteries in congenital heart diseases with decreased pulmonary blood flow[J].J Thorac Cardiovasc Surg,1984,88:610-619.
27.Kim W H,Otsuji Y,Yuasa T,et al.Evaluation of right ventricular dysfunction in patients with cardiac amyloidosis using Tei index[J].Am Soc Echocardiogr 2004,17(1):45-49.
28.童双立,多层螺旋CT的新进展.CT理论与应用研究,2005,14:50.
29.Nikolaou K,Fiohr T,Knez A,et al.Advances in cardiac imaging:64 slice scanner[J].Cardiovase Imaging,2004,20(6):535-540.
30.Williams BJ,Mulvihill DM,Pettus BJ.et al.Pediatric superior vena cava syndrome:assessment at low radiation dose 64-slice CT angiography.[J].Thorac Imaging,2006,21(1):71-72.
31.张雪莲,王巧兮,马兵毅,等.多层螺旋CT在诊断法洛四联症中的应用.中国介入影像与治疗学,2006,3(6):425-427.
32.石明国,宦怡,毛松寿.多层面CT的进展及应用.第四军医大学学报,2000,20:625.
33.王希高,王常忠,邢同芝.多层螺旋CT的功能特点及临床应用.临沂医学专科学校学报,2004,26:251.
34.王荣品.多层螺旋CT在复杂型先天性心脏病中的应用.临床放射学杂志,2007,26(5):516-518.
35.王荣品,先正元,杨明放,等.多层螺旋CT对复杂型先天性心脏病的诊断价值[J].临床放射学杂志,2007,26(4):341-346.
36.黄美萍,梁长虹,曾辉,等.多层螺旋CT在小儿复杂先天性心脏病诊断中的应用.中华放射学杂志,2004,38:726.
37.龚洪翰,蒋海清,韩萍,等.多层螺旋CT后处理技术临床应用[M].南昌:江西科学技术出版社.2004,193-196.
38.Schaffier Gj,Sorantin E,Groell R,et al.Helical CT angiography with maximum intensity projection in the assessment of aortic coarction after surgery.AJR,2000,175:1041-1045.
39.Yama N,Koito K,Hareyama M,et al.Tracheal bronchus mimicking bronchial intubation endoscopically:report of a case with air way bum[J].Am J Emerg Med,2005,23(6):815-816.
40.Munro HM,Sorbello AM,Nykanen DG.Severe stenosis of a long tracheal segment,with agensis of the right lung and left pulmonary arterial sling[J].Cardial Young,2006,16(1):89-91.
41.Loukanov T,Sebening C,Springer W,et al.Simultaneous management of congenital tracheal stensios and cardiac anomalies in infants[J].Thorac Cardiovasc Surg,2005,130(6):1537-1541.
42.Gilkeson RC,Ciancibello L,Zahka K.Multidetector CT evaluation of congenital heart disease in pediatric and adult patients.AJR,2003,180:973.
43.杨敏洁,夏黎明,江文涛,等.肺动脉闭锁伴室间隔缺损的多层螺旋CT诊断.放射学实践,2005,20:489.
44.Jonson H,Lvert T,Jonasson R,et al.Work capacity and central hemodynamic thirteen to twenty-six year after repair of tetralogy of Fallot[J].Thorac Cardiovasc Surg,1995,110(3):416-426.
45.Okita Y,Miki S,Ueda Y,et al.Early and lateresults of repair of tetralogy of Fallot with subarterial ventricular septal defect[J].Thorac Cardiovasc Surg,1995,109(1):180-185.
46.黄美萍,梁长虹,曾辉,等.多层螺旋CT在小儿复杂先天性心脏病诊断中的应用.中华放射学杂志,2004,38(7):726.
47.Nieman K,Rensing BJ,Van Geuns RJ,et al.Non-invasive coronary angiography with multislice spiral computed tomography:impact of heart rate[J].Heart,2002,88(5):470-474.
48.Kawano T,Ishii M,Takagi J,et al.Three-dimensional helical computed tomographic angiography in neonates and infants[J].Am J Roentgend,2000,175(5):1381-1386.
49.Hall EJ.Lessons We Have Learned from Our Children:Cancer Risks from Diagnostic Radiology[J].Pediatr Radiol,2002,32(10):700-706.
50.孙爱敏,朱铭,钟玉敏,等.16层螺旋CT在先天性心脏病诊断中的应用.放 射学实践,2007,22(3):252-255.
51.Klingerbeck R,Schaller S,Fhlor T,et al.Subsecond multislice computed tomography,basis and applications,Eur[J].Radiol,1999,31:110-124.
52.Carrascosa PM,Capunay CM,Parodj JC,et al.General utilities of multislice tomography in the cardiac field.Herz,2003,28(1):44-51.
53.Gilkeson RC,Ciancibello L,Kenneth Z.Multidetector CT evaluation of congenital heart disease in pediatric and adult patients.AJR,2003,180:973-980.
54.Goo HW,Ko FK,Kim YH,et al.CT of congenital heart disease:Normal anatomy and typical pathologic conditions.Radiographics,2003,23:S147-S165.
55.郝晶,李坤成.心脏的多层螺旋CT检查.中国医学影像技术,2002,18:601.
2.刘迎龙.法洛四联症.继续医学教育.2006,20(18):7-11.
3.刘锦纷,孙彦隽,苏肇伉,等.2186例小儿法洛氏四联症外科治疗析[J].上海第二医科大学学报,2004,24(3):165-168.
4.Rhodes J,O'Bfien S,Patel H,et al.Palliative balloon pulmonary valvuloplasty in tetralogy of fallot:echocardiographic predictors of successful outcome[J].Invasive Cardiol,2000,12(9):448-451.
5.高文根,张仁福,汪曾炜,等.婴儿法洛氏四联症外科治疗的危险因素分析[J].中华小儿外科杂志,2004,25(5):417-419.
6.杨思源,主编.小儿心脏病学.人民卫生出版社,2000,183-184.
7.Kawano T,lahii M,Takagi J,et al.Three-dimensional helical computed tomographic angiography in neonates and infants with complex congenital heart disease[J].Am Heart J,2000,139(2):654-660.
8.Haramati LB,Gickstein JS,Issenberg HJ,et al.MR imaging and CT vascular anomalies and connections in patients with congenital heart disease:significance in surgical planning[J].Radiographics,2002,22(4):337-341.
9.Wolfson BJ.Radiologic interpretation of congenital heart disease[J].Clin Perinatol,2001,28(1):71-74.
10.朱铭,李玉华,钟玉敏.增强MR血管造影在儿童先天性心脏病诊断中的应用[J].中华放射学杂志,2002,36(2):123.
11.朱杰明.儿童CT诊断学[M].上海科技出版社,2003,3-13.
12.Kerkhoff,Gert,Schmermund,Axel,Moehlenkamp,Stephan,et al.Noninvasive plaque imaging using contrast-enhanced cardiac computed tomomgraphy[J].Herz,2003,28(6):521-529.
13.Shiraishi I,Sorantin E,Groell R,et al.Helical CT angiography in obstructed total anomalous pulmonary venous drainge[J].AJR,2000,175(4):1041-1045.
14.黄美萍,梁长虹,曾辉,等.小儿先天性心脏病肺动脉发育多层螺旋CT研究[J].放射学实践,2004,19(8):608-611.
15.Knez A,Becker CR,Leber A,et al.Usefulness of multislice spiral computed tomography angiography for determination of coronary artery disease[J].Am J Cardiol,2001,88(10):1191-1194.
16.Nieman K,Rensing BJ,Van Geuns RJ,et al.Usefulness of multislice spiral computed tomography angiography for determination of coronary artery disease [J].Am J Cardiol,2002,89(8):913-918.
17.Rhodes J,O'Brien S,Patel H,et al.Palliative balloon pulmonary valvuloplasty in tetralogy of fallot:echocardiographic predictors of successful outcome[J].Invasive Cardiol,2000,12(9):448-451.
18.王荣品,先正元,杨明放,等.多层螺旋CT对复杂型先天性心脏病的诊断价值[J].临床放射学杂志,2007,26(4):341-346.
19.龚洪翰,蒋海清,韩萍,等.多层螺旋CT后处理技术临床应用[M].南昌:江西科学技术出版社,2004,193-196.
20.Bean M J,Pannu H,Fisheman EK.Three-Dimenasional computed tomographic imaging of complex congenital cardiovascular abnonmailties[J].Comput Assist Tomogr,2005,29:721.
21.Gilkeson RC,Ciancibello L,Zahka K.Multidetector CT evaluation of congenital heart disease in pediatric and adult patients.AJR,2003,180:973.
22.Fontan F,Fernandez G,Costa F,et al.The size of pulmonary arteries and the results of the Fontan operation.J Thorac Cardiovasc Surg,1989,98(4):711-724.
23.胡咏梅,等.人体体表面积实测值与Stevenson公式计算值比较.新乡医学院学报,1996,16(3):228-230.
24.Jonson H,Lvert T,Jonasson R,et al.Work capacity and central hemodynamic thirteen to twenty-six year after repair of tetralogy of Fallot[J].Thorac Cardiovasc Surg,1995,110(3):416-426.
25.Okita Y,Miki S,Ueda Y,et al.Early and lateresults of repair of tetralogy of Fallot with subarterial ventricular septal defect[J].Thorac Cardiovasc Surg,1995,109(1):180-185.
26.Frank L,Rita D,Andrea M,et al.Impact of blunted pulmonary venous flow on the outcome of patients with left ventricular systolic dysfunction secondary to either ischemic or idiopathic dilated cardiomyopathy.Am J Cardiol,2000,85(6):1455-1460.
27.Reza Sabri M,Sholler G,Hawker R,et al.Branch pulmonary artery growth after Blalock-Taussing shunts in tetralogy of fallot and pulmonary atresia with ventricular septal defect:A Retrospective,Echocardiographic study[J].Pediatr Cardiol,1999,20(5):358-363.
28.Nakata S,Imai Y,Takanashi Y,et al.A new method for the quantitative standardization of cross-sectional areas of the pulmonary arteries in congenital heart diseases with decreased pulmonary blood flow[J].Thorac Cardiovasc Surg,1984,88:610-619
29.李向民,周旭辉,杨有优,等.电子束CT诊断婴幼儿先天性心脏病并与超声心动图及手术对照.中华放射杂志,2003,37:644.
30.Funabashi N,Rubin GD.Qualitative blood flow differentiation-de-picition of a left to right cardiac shunt across aventricular septal defect using Electron-beam computed tomography.Japan Cite[J].2000,64:901.
31.Boechat MI,Ratib O,Williams PL,et al.Cardiac MR imaging and MR angiography for assessment of complex tetralogy of Fallot and pulmonary atresia.Radiaographica,2005,25:1535.
32.Boxt LM.Magnetic resonance and computed tomographic evaluation of congenital heart disease[J].Magn Resort Imaging,2004,19:827.
33.Rebergen,Sidney A.,de Roos,Albert,et al.Congenital heart disease.Evaluation of anatomy and function by MRI[J].Herz,2000,25(4):365-383.
34.Sklansky M.Advances in Fetal Cardiac Imaging.Pedistr Cardiol,2004,25:307.
35.Shiraishi I,Yamagishi M,Iwasaki N,et al.Helical computed tomographic angiography in obstructed total anomalous pulmonary venous drainage[J].Ann Thorac Surg,2001,71(5):1690-1692.
36.Masiello P,Santoro G,Franzesi E,et al.Aortic pseudo coarctation:spiral volumetric computed tomography imaging[J].Ann Thorac Surg,1999,68(4): 1421.
37.Achenbach S,Ulzheimer S,Baum U,et al.Noninvasive coronary angiography by retrospectively ECG gated multislise spiral CT[J].Circulation,2000,102(23):2823-2828.
38.Schaffier Gj,Sorantin E,Groell R,et al.Helical CT angiography with maximum intensity projection in the assessment of aortic coarction after surgery.AJR,2000,175:1041-1045.
39.Wesra S J,Hill JA,Alejos JC,et al.Three-dimensional helical CT of pulmonary arteries in infants and children with congenital heart disease[J].AJR,1999,173(1):109-115.
40.Hemininger BM,Molina PL,Egain TM,et al.Assesament of realtime 3D visualization for cardiothoracic diagnostic evaluation and surgery planning.Journal of Digital Imaging,2005,18(2):145.
41.Klingerbeck R,Schaller S,Fhlor T,et al.Subsecond multislice computed tomography,basis and applications,Eur[J].Radiol,1999,31:110-124.
42.Carrascosa PM,Capunay CM,Parodj JC,et al.General utilities of multislice tomography in the cardiac field.Herz,2003,28(1):44-51.
43.Gilkeson RC,Ciancibello L,Kenneth Z.Multidetector CT evaluation of congenital heart disease in pediatric and adult patients.AJR,2003,180:973-980.
44.Goo HW,Ko FK,Kim YH,et al.CT of congenital heart disease:Normal anatomy and typical pathologic conditions.Radiographics,2003,23:S147-S165.
45.Siegel MJ.Multiplanar and Three2dimensional Multi2detector Row CT of Thoracic Vessels and Airways in t he Pediatric Population[J].Radiology,2003,229(3):641-650.
46.黄美萍,梁长虹,曾辉,等.多层螺旋CT在小儿复杂先天性心脏病诊断中的应用.中华放射学杂志,2004,38(7):726.
47.Nieman K,Rensing BJ,Van Geuns RJ,et al.Non-invasive coronary angiography with multislice spiral computed tomography:impact of heart rate[J].Heart.2002,88(5):470-474.
48.Kawano T,Ishii M,Takagi J,et al.Three-dimensional helical computed tomographic angiography in neonates and infants[J].Am J Roentgend,2000,175(5):1381-1386.
49.Hall EJ.Lessons We Have Learned from Our Children:Cancer Risks from Diagnostic Radiology[J].Pediatr Radiol,2002,32(10):700-706.
50.孙爱敏,朱铭,钟玉敏,等.16层螺旋CT在先天性心脏病诊断中的应用.放射学实践.2007,22(3):252-255.
1.Samyn MM,A review of the complementary information available with cardiac magnetic resonance imaging and multi2slice computed tomography(CT) during the study of congenital heart disease.Inter[J].Cardiovas Image,2004,20:569.
2.陶中良,张玉玲,孙向东,等.常见先天性心脏病的诊断与手术治疗.河南外科学杂志,2003,9:4.
3.周爱卿,主编.心导管术2先天性心脏病诊断与治疗.济南:山东科学技术出版社,1997,160.
4.高云华.先天性心脏病的超声诊断方法及进展.临床超声医学志,2002,4:188.
5.汪曾炜,刘维永,张宝仁,心脏外科学[M].北京:人民军医出版社,2003,1:878-933.
6.刘迎龙.法洛四联症.继续医学教育.2006,20(18):7-11.
7.朱铭,李玉华,钟玉敏.增强MR血管造影在儿童先天性心脏病诊断中的应用[J].中华放射学杂志,2002,36(2):123.
8.朱杰明.儿童CT诊断学[M].上海:上海科技出版社,2003,3-13.
9.朱铭.儿童先天性心脏病影像诊断.中国实用儿科学杂志.2004,19(3):186-188.
10.Sokol I,Vineelj J.Kifin M.Echocardiographic features of adult Tetralogy of Fallot with natural palliative correction by patent ductus arteriosus[J].2003,44(2):234-238.
11.Sklansky M.Advances in Fetal Cardiac Imaging.Pedistr Cardiol,2004,25:307.
12.Kerkhoff,Gert,Schmermund,Axel,Moehlenkamp,Stephan,et al.Noninvasive plaque imaging using contrast-enhanced cardiac computed tomomgraphy[J].Herz,2003,28(6):521-529.
13.Shiraishi I,Sorantin E,Groell R,et al.Helical CT angiography in obstructed total anomalous pulmonary venous drainge[J].AJR,2000,175(4):1041-1045.
14.Shiraishi I,yamagishi M,Iwasaki N,et al.Three-dimensional helical computed tomographic angiography in obstructed total anomalous pulmonary venous drainage[J].Ann Thorac Surg,2001,71(7):1690-1692.
15.金泽宁,谢若兰,戴汝平,等.先天性心脏病心肺动脉发育情况的电子束CT 与心血管造影对照研究[J].中华放射学杂志,1998,32(8):515-518.
16.Boechat MI,Ratib O,Williams PL,et al.Cardiac MR imaging and MR angiography for assessment of complex tetralogy of Fallot and pulmonary atresia.Radiaographica,2005,25:1535.
17.Boxt LM.Magnetic resonance and computed tomographic evaluation of congenital heart disease[J].Magn Reson Imaging,2004,19:827.
18.Rebergen,Sidney A.,de Roos,Albert,et al.Congenital heart disease.Evaluation of anatomy and function by MRI[J].Herz,2000,25(4):365-383.
19.李向民,周旭辉,杨有优,等.电子束CT诊断婴幼儿先天性心脏病并与超声心动图及手术对照.中华放射杂志,2003,37:644.
20.Funabashi N,Rubin GD.Qualitative blood flow differentiation-de-picition of a left to right cardiac shunt across aventricular septal defect using Electron-beam computed tomography.Japan Cire[J].2000,64:901.
21.Samyn MM,A review of the complementary information available with cardiac magnetic resonance imaging and multi-slice computed tomography(CT)during the study of congenital heart disease[J].Inter J Cardiovas Imag,2004,20:569.
22.刘锦纷,孙彦隽,苏肇伉,等.2186例小儿法洛氏四联症外科治疗分析[J].上海第二医科大学学报,2004,24(3):165-168.
23.高文根,张仁福,汪曾炜,等.婴儿法洛氏四联症外科治疗的危险因素分析[J].中华小儿外科杂志.2004,25(5):417-41.
24.Borowski A,Ghodsizad A,Litmathe J,et al.Severe pulmonary.Regu tation late after total repair of tetralogy of Fallot:surgical considerations[J].Pediatr Cardiol,2004,25(2):466-471.
25.Xiao TT,Chen SB,Zhang YQ,et al.Exploration of methods for evaluating the development of pulmonary arteries in tetralogy of Fallot[J].Cardiovasc Pulmonary Dis(Chinese),2002,21(1):26-28.
26.Nakata S,Imai Y,Takanashi Y,et al.A new method for the quantitative standardization of cross-sectional areas of the pulmonary arteries in congenital heart diseases with decreased pulmonary blood flow[J].J Thorac Cardiovasc Surg,1984,88:610-619.
27.Kim W H,Otsuji Y,Yuasa T,et al.Evaluation of right ventricular dysfunction in patients with cardiac amyloidosis using Tei index[J].Am Soc Echocardiogr 2004,17(1):45-49.
28.童双立,多层螺旋CT的新进展.CT理论与应用研究,2005,14:50.
29.Nikolaou K,Fiohr T,Knez A,et al.Advances in cardiac imaging:64 slice scanner[J].Cardiovase Imaging,2004,20(6):535-540.
30.Williams BJ,Mulvihill DM,Pettus BJ.et al.Pediatric superior vena cava syndrome:assessment at low radiation dose 64-slice CT angiography.[J].Thorac Imaging,2006,21(1):71-72.
31.张雪莲,王巧兮,马兵毅,等.多层螺旋CT在诊断法洛四联症中的应用.中国介入影像与治疗学,2006,3(6):425-427.
32.石明国,宦怡,毛松寿.多层面CT的进展及应用.第四军医大学学报,2000,20:625.
33.王希高,王常忠,邢同芝.多层螺旋CT的功能特点及临床应用.临沂医学专科学校学报,2004,26:251.
34.王荣品.多层螺旋CT在复杂型先天性心脏病中的应用.临床放射学杂志,2007,26(5):516-518.
35.王荣品,先正元,杨明放,等.多层螺旋CT对复杂型先天性心脏病的诊断价值[J].临床放射学杂志,2007,26(4):341-346.
36.黄美萍,梁长虹,曾辉,等.多层螺旋CT在小儿复杂先天性心脏病诊断中的应用.中华放射学杂志,2004,38:726.
37.龚洪翰,蒋海清,韩萍,等.多层螺旋CT后处理技术临床应用[M].南昌:江西科学技术出版社.2004,193-196.
38.Schaffier Gj,Sorantin E,Groell R,et al.Helical CT angiography with maximum intensity projection in the assessment of aortic coarction after surgery.AJR,2000,175:1041-1045.
39.Yama N,Koito K,Hareyama M,et al.Tracheal bronchus mimicking bronchial intubation endoscopically:report of a case with air way bum[J].Am J Emerg Med,2005,23(6):815-816.
40.Munro HM,Sorbello AM,Nykanen DG.Severe stenosis of a long tracheal segment,with agensis of the right lung and left pulmonary arterial sling[J].Cardial Young,2006,16(1):89-91.
41.Loukanov T,Sebening C,Springer W,et al.Simultaneous management of congenital tracheal stensios and cardiac anomalies in infants[J].Thorac Cardiovasc Surg,2005,130(6):1537-1541.
42.Gilkeson RC,Ciancibello L,Zahka K.Multidetector CT evaluation of congenital heart disease in pediatric and adult patients.AJR,2003,180:973.
43.杨敏洁,夏黎明,江文涛,等.肺动脉闭锁伴室间隔缺损的多层螺旋CT诊断.放射学实践,2005,20:489.
44.Jonson H,Lvert T,Jonasson R,et al.Work capacity and central hemodynamic thirteen to twenty-six year after repair of tetralogy of Fallot[J].Thorac Cardiovasc Surg,1995,110(3):416-426.
45.Okita Y,Miki S,Ueda Y,et al.Early and lateresults of repair of tetralogy of Fallot with subarterial ventricular septal defect[J].Thorac Cardiovasc Surg,1995,109(1):180-185.
46.黄美萍,梁长虹,曾辉,等.多层螺旋CT在小儿复杂先天性心脏病诊断中的应用.中华放射学杂志,2004,38(7):726.
47.Nieman K,Rensing BJ,Van Geuns RJ,et al.Non-invasive coronary angiography with multislice spiral computed tomography:impact of heart rate[J].Heart,2002,88(5):470-474.
48.Kawano T,Ishii M,Takagi J,et al.Three-dimensional helical computed tomographic angiography in neonates and infants[J].Am J Roentgend,2000,175(5):1381-1386.
49.Hall EJ.Lessons We Have Learned from Our Children:Cancer Risks from Diagnostic Radiology[J].Pediatr Radiol,2002,32(10):700-706.
50.孙爱敏,朱铭,钟玉敏,等.16层螺旋CT在先天性心脏病诊断中的应用.放 射学实践,2007,22(3):252-255.
51.Klingerbeck R,Schaller S,Fhlor T,et al.Subsecond multislice computed tomography,basis and applications,Eur[J].Radiol,1999,31:110-124.
52.Carrascosa PM,Capunay CM,Parodj JC,et al.General utilities of multislice tomography in the cardiac field.Herz,2003,28(1):44-51.
53.Gilkeson RC,Ciancibello L,Kenneth Z.Multidetector CT evaluation of congenital heart disease in pediatric and adult patients.AJR,2003,180:973-980.
54.Goo HW,Ko FK,Kim YH,et al.CT of congenital heart disease:Normal anatomy and typical pathologic conditions.Radiographics,2003,23:S147-S165.
55.郝晶,李坤成.心脏的多层螺旋CT检查.中国医学影像技术,2002,18:601.