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目的 探讨电子束CT(EBCT)诊断先天性主动脉瓣下隔膜型狭窄的实用价值。方法对EBCT造影诊断为先天性主动脉瓣下隔膜型狭窄的 4例患者进行回顾性分析研究 ,全部病例均经普通X线、超声心动图检查 ,1例行心血管造影 ,2例经手术及病理证实。EBCT检查采用心电门控单层连续容积扫描和心脏长、短轴面电影扫描。结果 4例先天性主动脉瓣下隔膜型狭窄患者的EBCT图像均清晰显示出主动脉瓣下隔膜状的负性充盈征象。 1例合并镜面右位心、主动脉瓣关闭不全 ,1例合并动脉导管未闭、房间隔缺损和主动脉瓣、二尖瓣病变 ,1例合并有室间隔缺损、右位主动脉弓 (Ⅱ型 ) ,1例合并有主动脉瓣、二尖瓣关闭不全。结论 EBCT对先天性主动脉瓣下隔膜型狭窄及并发的心血管畸形可以获得准确的病理解剖诊断 ,能满足临床诊断和手术治疗的要求 ,在左室流出道局部细节的显示上甚至优于常规的心血管造影。在术后随诊观察方面可取代心血管造影。
Objective To investigate the practical value of electron beam computed tomography (EBCT) in diagnosing congenital aortic subvalvular stenosis. Methods Four cases of congenital aortic subvalvular stenosis diagnosed by EBCT were retrospectively analyzed. All the cases were examined by X-ray and echocardiography. One case underwent cardiovascular angiography and two cases underwent surgery and Pathology confirmed. EBCT examination ECG-controlled single-layer continuous volume scanning and cardiac long and short axis movie scanning. Results The EBCT images of 4 patients with congenital aortic subvalvular stenosis clearly showed negative aortic subvalvular filling signs. One patient had combined right-sided mirror, aortic valve insufficiency, patent ductus arteriosus, atrial septal defect, aortic valve and mitral valve disease in one case, ventricular septal defect in one case, right aortic arch (type Ⅱ) , 1 case with aortic valve, mitral regurgitation. Conclusion EBCT can obtain accurate pathological anatomy diagnosis of congenital aortic subvalvular stenosis and concomitant cardiovascular malformations, which can meet the requirements of clinical diagnosis and surgical treatment. It is even superior to the conventional method in displaying the local details of left ventricular outflow tract Cardiovascular angiography. In postoperative follow-up observation can replace cardiovascular imaging.