CAJ | 학술논문

目的探讨炫速双源CT诊断法洛四联症(TOF)的应用价值.方法对比分析42例法洛四联症患者的术前双源CT、超声心动检查资料和术中主肺动脉(PA)、左肺动脉(LPA)、右肺动脉(RPA)、右室流出道(ROVT)及主动脉骑跨率测量值,以术中测量结果为基准.结果 42例患者术中共发现心脏畸形232处,其中心内畸形145处,心脏大血管连接处畸形53处,心外畸形34处.术前炫速双源CT发现心脏畸形204处,其中心内畸形130处,心脏大血管连接处畸形21处,心外畸形53处；超声心动检查发现224处,其中心内畸形145处,心脏大血管连接处畸形31处,心外畸形48处；确诊率分别为88％(204/232处)和97％(224/232处).炫速双源CT检查结果和术中两组测量值相比较差异无统计学意义(P＞0.05).超声心动检查结果和术中测量值相比,PA、LPA和RPA差异有统计学意义(P＜0.05),ROVT和主动脉骑跨率相比较差异无统计学意义(P＞0.05).超声心动检查和炫速双源CT相比较,差异无统计学意义(P＞0.05),二者具有很好的一致性.结论超声心动检查诊断心腔内结构畸形优于炫速双源CT.诊断心外大血管畸形,尤其是评估TOF患者肺动脉发育情况,炫速双源CT具有其独特的优势,两种方法结合对TOF患者的诊断有明显的互补作用.
목적 탐토현속쌍원CT진단법락사련증(TOF)적응용개치.방법 대비분석42례법락사련증환자적술전쌍원CT、초성심동검사자료화술중주폐동맥(PA)、좌폐동맥(LPA)、우폐동맥(RPA)、우실류출도(ROVT)급주동맥기과솔측량치,이술중측량결과위기준.결과 42례환자술중공발현심장기형232처,기중심내기형145처,심장대혈관련접처기형53처,심외기형34처.술전현속쌍원CT발현심장기형204처,기중심내기형130처,심장대혈관련접처기형21처,심외기형53처；초성심동검사발현224처,기중심내기형145처,심장대혈관련접처기형31처,심외기형48처；학진솔분별위88％(204/232처)화97％(224/232처).현속쌍원CT검사결과화술중량조측량치상비교차이무통계학의의(P＞0.05).초성심동검사결과화술중측량치상비,PA、LPA화RPA차이유통계학의의(P＜0.05),ROVT화주동맥기과솔상비교차이무통계학의의(P＞0.05).초성심동검사화현속쌍원CT상비교,차이무통계학의의(P＞0.05),이자구유흔호적일치성.결론 초성심동검사진단심강내결구기형우우현속쌍원CT.진단심외대혈관기형,우기시평고TOF환자폐동맥발육정황,현속쌍원CT구유기독특적우세,량충방법결합대TOF환자적진단유명현적호보작용.
Objective To investegate the value of dual-source CT (DsCT) in the diagnosis of tetralogy of Fallot (TOF).Methods The measurement results of the main pulmonary artery( PA),left pulmonary artery (LPA),right pulmonary artery( RPA ),right entricular outflow tract(ROVT) of 42 cases with TOF by DsCT,echocardiography aud surgery were ret rospectively analyzed.Results Of the 42 cases,a total of 232 cardiac nomalies were found by surgery ( 145 intra cardiac anomalies,53 ventricular-aterial connection anomalies,34 external cardiac anomalies),DsCT and echocardiography found 204 cardiac nomalies (130 intra cardiac anomalies,12 ventricular-aterial connection anomalies,53 external cardiac anomalies),224 cardiac nomalies ( 145 intra cardiac anomalies,31 ventricular-aterial connection anomalies,48 external cardiac anomalies)respectively;and the diagnostic accuracy of DsCT and echocardiography was 88％ (204/232),97％ (224/232) respectively.There was not significant difference between DsCT and surgery ( P ＞ 0.05 ).There was significant difference between echocardiography and surgery in PA,LPA and RPA (P＜0.05),but not in ROVT and over-riding of the aorta (P＞0.05).There was not significant difference between DsCT and echocardiography ( P ＞ 0.05 ).Conclusion Echocardiography was superior to DsCT in intra cardiac anomalies,especially in the cardiac septal defects and heart valve diseases.DsCT had the advantages in external cardiac anomalies,particularly in assessing pulmonary artery.