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目的评价一站式MRI对复杂先天性心脏病的诊断价值。资料与方法对33例复杂先天性心脏病患儿进行MRI扫描,包括梯度回波序列及自旋回波序列平扫,梯度回波序列电影扫描及三维增强磁共振血管成像(3D-CE MRA)扫描。将患儿MRI影像资料分为平扫+电影(A组)及平扫+电影+3D-CE MRA(B组)两组图像分别进行分析诊断,以手术作为参考标准,评估其诊断价值,并与B超结果进行对照。结果 22例成功完成一站式MRI扫描并经手术证实,共计109处心脏大血管异常,包括心内结构异常46处,心外结构异常63处。A组整体正确诊断率为84.4%,其中心内结构异常及心外结构异常的正确诊断率分别为82.6%、85.7%。B组整体正确诊断率为90.8%,其中心内结构异常及心外结构异常的正确诊断率分别为82.6%、96.8%。B超整体正确诊断率为82.6%,其中心内结构异常及心外结构异常的正确诊断率分别为87.0%、79.4%。结论一站式MRI扫描能明显提高心外大血管异常的正确诊断率,对心内结构异常诊断无明显帮助。与B超比较,MRI平扫+电影及一站式MRI平扫对心内结构异常的诊断均不如B超,对心外结构异常的诊断均比B超更具优势。
Objective To evaluate the diagnostic value of one-stop MRI for complex congenital heart disease. Materials and Methods MRI was performed in 33 children with complicated congenital heart disease, including gradient echo sequence and spin echo sequence scan, gradient echo sequence scan and 3D-CE MRA scan . The MRI images of children were divided into two groups: plain scan + movie (group A) and plain scan + movie + 3D-CE MRA (group B). The data of two groups were analyzed and diagnosed respectively. The operation was used as the reference standard to evaluate the diagnostic value, B-ultrasound results and control. Results Twenty-two patients successfully completed a one-stop MRI scan and confirmed by operation. A total of 109 cardiac major vessel abnormalities were observed, including 46 intracardiac structures and 63 extracardiac structures. The overall correct diagnosis rate of group A was 84.4%. The correct diagnosis rates of intracardiac structural abnormalities and extracardiac structural abnormalities were 82.6% and 85.7% respectively. The overall correct diagnosis rate in group B was 90.8%. The correct diagnosis rates of intracardiac structural abnormalities and extracardiac structural abnormalities were 82.6% and 96.8% respectively. The correct diagnosis rate of B ultrasound was 82.6%. The correct diagnosis rates of intracardiac structural abnormalities and extracardiac structural abnormalities were 87.0% and 79.4% respectively. Conclusion One-stop MRI can significantly improve the correct diagnosis rate of extracardiac macrovascular abnormalities without any obvious help in the diagnosis of intracardiac structural abnormalities. Compared with B ultrasound, MRI plain film + one-stop MRI scan of intracardiac structures are not as good as the diagnosis of B-ultrasound, the diagnosis of extracardiac structures are more advantages than B-ultrasound.