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目的研究16层螺旋CT血管造影(MSCTA)及其三维重建在先天性心脏病(简称先心病)肺静脉异位引流中的应用价值。方法对12例手术证实的异位引流肺静脉干38支进行分析,所有病例均行MSCT增强扫描,随后在工作站进行三维重建,并与12例经胸超声心动(TTE)及心血管造影(CAG)结果进行对比。结果手术证实异位引流肺静脉干38支,其中完全型异位引流肺静脉干32支,其中心上型24支、心内型8支,部分型异位引流肺静脉干6支,其中心上型3支、心内型3支。MSCTA、TTE、CAG诊断准确率分别为100%、81.6%、97.4%,MSCTA及CAG诊断准确率与TTE诊断准确率有显著性差异(χ2=7.71,P<0.01)、(χ2=5.03,P<0.05),MSCTA与CAG诊断准确率无显著性差异(χ2=1.01,P>0.05)。结论MSCTA及其三维重建对先心病异位引流肺静脉诊断与CAG诊断无显著性差异,是一种很好的无创检查方法。
Objective To study the value of 16-slice spiral CT angiography (MSCTA) and its three-dimensional reconstruction in the heterotopic pulmonary venous drainage in patients with congenital heart disease (CHD). Methods Thirty-eight cases of ectopic drainage pulmonary veins confirmed by surgery were analyzed. MSCT enhanced scanning was performed in all the cases. Three-dimensional reconstruction was performed at the workstation and compared with 12 cases of transthoracic echocardiography (TTE) and angiography (CAG) The results are compared. Results The operation of the ectopic drainage of 38 pulmonary veins was confirmed, of which 32 were exclusively ectopic drainage of the pulmonary veins, of which 24 were in the upper center, 8 were in the heart, 6 were partially ectopic drainage of the pulmonary veins, Branch, heart type 3. The diagnostic accuracy rates of MSCTA, TTE and CAG were 100%, 81.6% and 97.4% respectively. The diagnostic accuracy of MSCTA and CAG was significantly different from that of TTE (χ2 = 7.71, P <0.01) <0.05). The diagnostic accuracy of MSCTA and CAG had no significant difference (χ2 = 1.01, P> 0.05). Conclusion MSCTA and its three-dimensional reconstruction in the diagnosis of congenital heart disease with anomalous pulmonary venous drainage and CAG no significant difference, is a good noninvasive detection method.