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目的 探讨电子束CT(EBCT)在肺静脉异常连接诊断中的临床价值。材料与方法 EBCT诊断肺静脉异常连接患者 2 1例 ,其中男 13例 ,女 8例。年龄 3～ 63岁 ,平均 15 .6岁。 17例行增强单层容积扫描 ,4例行增强连续容积扫描。全部病例均行表面阴影显示法三维重建。 17例有心血管造影或手术结果 ,其中 9例单纯行造影 ,4例单纯行手术 ,4例造影后手术。结果 2 0例术前资料 ,EBCT诊断为完全型肺静脉异常连接 12例 ,部分型肺静脉异常连接 8例。前者包括心上型 3例 ,心脏型 8例和混合型 1例。EBCT均清晰显示异常连接肺静脉的数目、分布和位置。 1例术后复查病例 ,EBCT示吻合口狭窄。 7例完全型肺静脉异常连接者 ,EBCT提示合并内脏心房异位综合征。 8例有手术对照者 ,EBCT对肺静脉异常连接的定性、定位诊断全部正确。结论 EBCT及其三维重建可准确显示异常连接肺静脉的位置、数目和术后狭窄 ,对明确胸腹并发畸形有明显优势 ,是一种重要的无创性诊断肺静脉异常连接的方法。
Objective To investigate the clinical value of electron beam computed tomography (EBCT) in the diagnosis of pulmonary venous anomalies. Materials and Methods EBCT diagnosed pulmonary vein abnormalities in 21 patients, including 13 males and 8 females. Aged 3 to 63 years old, with an average of 15.6 years old. 17 cases enhanced monolayer volume scanning, 4 cases of enhanced continuous volume scanning. All patients underwent three-dimensional reconstruction of the surface shadow display method. Seventeen patients underwent angiography or surgery, including 9 cases of simple radiography, 4 cases of simple surgery and 4 cases of angiography. Results 20 cases of preoperative data, EBCT diagnosis of complete pulmonary anomalous connection in 12 cases, partial anomalous pulmonary veins in 8 cases. The former includes 3 cases of cardiac type, 8 cases of heart type and 1 case of mixed type. EBCT clearly shows the number, distribution and location of abnormally connected pulmonary veins. A case of postoperative review of cases, EBCT showed anastomotic stenosis. Seven cases of complete anomalous pulmonary venous connection, EBCT suggestive of visceral atrial ectopic syndrome. 8 cases of surgical control, EBCT on the pulmonary vein abnormal connection qualitative diagnosis of all correct positioning. Conclusions EBCT and its three-dimensional reconstruction can accurately show the location and number of abnormally connected pulmonary veins and postoperative stenosis. It has obvious advantages in identifying complicated abnormalities of the chest and abdomen. It is an important noninvasive method to diagnose the abnormal connection of pulmonary veins.