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目的探讨64层螺旋CT(64-SCT)小儿冠状动脉造影的临床应用。方法对21例小儿患者行64-SCT冠状动脉造影检查,对冠状动脉疾病进行诊断。所有患者均行彩色多普勒检查,6例同时行DSA检查。结果21例行64-SCT小儿冠状动脉造影的患者中12例为冠状动脉发育异常,右冠状动脉双开口3例,左冠状动脉回旋支与右冠状动脉主干共干起源于主动脉右窦2例,左冠状动脉前降支与右冠状动脉共干起源于主动脉右窦2例,左冠状动脉前降支与左冠状动脉回旋支均直接起源于主动脉左窦2例,左冠状动脉起源于肺动脉1例,1例左右冠状动脉起源正常但所有冠状动脉均匀性迂曲增粗,1例左冠状动脉主干闭塞,右冠状动脉迂曲增粗并伴有多发侧枝循环。6例患者为川崎病伴发冠状动脉单发或多发瘤样扩张。3例患者未见明显异常。所有同时行DSA检查的患者,除左冠状动脉起源于肺动脉主干的1例患者DSA诊断左冠状动脉缺如外,其余5例其诊断结果与64-SCT诊断结果相吻合。结论64-SCT是一种小儿冠状动脉疾病无创的、安全可靠的检查方法。
Objective To investigate the clinical application of 64-slice spiral CT (64-SCT) coronary angiography in children. Methods 21 cases of pediatric patients underwent 64-SCT coronary angiography, coronary artery disease diagnosis. All patients underwent color Doppler examination, 6 patients underwent DSA at the same time. Results Twelve of the 21 patients with 64-SCT pediatric coronary angiography had abnormal coronary artery development and three cases of double right coronary artery opening. The left coronary artery circumflex artery and the common trunk of the right coronary artery originated from the right sinus of the aorta in 2 cases , Left anterior descending coronary artery and right coronary artery co-stem originated in 2 cases of right aortic sinus, left anterior descending coronary artery and left circumflex coronary artery originated directly in the left aortic sinus in 2 cases, the left coronary artery originated in 1 case of pulmonary artery, 1 case of normal origin of coronary artery but all tortuous thickening of coronary artery, 1 case of left main coronary artery occlusion, tortuous thickening of the right coronary artery with multiple collateral circulation. 6 patients with Kawasaki disease associated with single or multiple tumor-like coronary artery-like expansion. No abnormalities were observed in 3 patients. All patients who underwent DSA at the same time, except one patient with left coronary artery originating from the trunk of the pulmonary artery, had DSA diagnosed as missing left coronary artery. The other five patients were diagnosed as coincident with 64-SCT diagnosis. Conclusion 64-SCT is a noninvasive, safe and reliable method for detecting coronary artery disease in children.