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目的探讨多层螺旋CT血管成像评价重症婴幼儿法洛四联症的临床应用价值。方法对2010年1月至2013年3月45例重症婴幼儿法洛四联症的患者术前行256层螺旋CT检查,34例行心电门控扫描,11例行普通扫描,所有病例均经后处理工作站进行分析,使用多平面重建(MPR)、最大密度投影(MIP)、容积重建(VR)和薄层图像进行综合评估,同时与经胸超声心动图(TTE)及手术结果对照。结果 45例患者中,手术证实256层螺旋CT畸形准确43例,TTE准确34例;其中TTE漏诊动脉导管未闭4例;主动脉缩窄7例;同时CT显示4例体肺动脉粗大侧枝。256层螺旋CT与TTE诊断的准确率分别为95.6%(43/45)、75.6%(34/45),两种检查方法准确率比较,差异有统计学意义(P<0.05)。结论 256层螺旋CT可作为重症婴幼儿法洛四联症术前诊断及合理制定手术方案的重要依据。
Objective To investigate the clinical value of multi-slice spiral CT angiography in the diagnosis of tetralogy of Fallot with severe infantile infants. Methods From January 2010 to March 2013, 45 patients with tetralogy of Fallot from severe infants underwent preoperative 256-slice spiral CT, 34 underwent gated gating and 11 underwent normal scanning. All patients The postprocessing workstation was used for the analysis and the comprehensive assessment was performed by using multiplanar reconstruction (MPR), maximum density projection (MIP), volume reconstruction (VR) and thin layer images and compared with transthoracic echocardiography (TTE) and surgical results. Results Of the 45 patients, 43 cases were correctly diagnosed by 256-slice spiral CT and 34 cases were TTE accurately. Among them, 4 cases were missed by patent ductus arteriosus and 7 cases were aorta narrowed. Totally 4 cases showed extensive pulmonary collateral. The diagnostic accuracy of 256-slice spiral CT and TTE were 95.6% (43/45) and 75.6% (34/45), respectively. The accuracy of the two methods was statistically significant (P <0.05). Conclusion 256-slice spiral CT can be used as a preoperative diagnosis of tetralogy of Fallot with severe infants and an important basis for the rational development of surgical options.