CAJ | 학술논문

目的研究高清CT(HDCT)容积螺旋穿梭技术(VHS)在诊断先天性心脏病(CHD)方面的应用价值.方法搜集行HDCT VHS扫描及超声心动图(ECHO)检查的CHD患者43例,分析经手术证实的24例(儿童21例,成人3例)HDCT结果,与ECHO结果进行对比,评价HDCT对CHD病变、血流动力学、冠状动脉及合并心外病变的显示能力.有效剂量(mSv)=剂量长度乘积(DLP) ×K.结果手术证实心内畸形36处,HDCT符合率100.0％(36处)与ECHO一致.心脏大血管连接部及心外血管畸形44处,HDCT符合率(95；4％,42/44)明显优于ECHO (59.1％,26/44).ECHO提示间隔缺损右向左及左向右分流分别为5和6例,HDCT均符合；双向分流14例,HDCT除1例观察不清外,其余13例仅显示右向左分流.HDCT冠状动脉开口及近段走行均完全显示.有效剂量:儿童(3.38±1.86) mSy,成人(10.27±2.59)mSv.结论 HDCT VHS诊断CHD中有较大优势,能够准确、无创地反映心脏、心外结构及血流动力学信息,为临床诊断提供帮助.
목적 연구고청CT(HDCT)용적라선천사기술(VHS)재진단선천성심장병(CHD)방면적응용개치.방법 수집행HDCT VHS소묘급초성심동도(ECHO)검사적CHD환자43례,분석경수술증실적24례(인동21례,성인3례)HDCT결과,여ECHO결과진행대비,평개HDCT대CHD병변、혈류동역학、관상동맥급합병심외병변적현시능력.유효제량(mSv)=제량장도승적(DLP) ×K.결과 수술증실심내기형36처,HDCT부합솔100.0％(36처)여ECHO일치.심장대혈관련접부급심외혈관기형44처,HDCT부합솔(95；4％,42/44)명현우우ECHO (59.1％,26/44).ECHO제시간격결손우향좌급좌향우분류분별위5화6례,HDCT균부합；쌍향분류14례,HDCT제1례관찰불청외,기여13례부현시우향좌분류.HDCT관상동맥개구급근단주행균완전현시.유효제량:인동(3.38±1.86) mSy,성인(10.27±2.59)mSv.결론 HDCT VHS진단CHD중유교대우세,능구준학、무창지반영심장、심외결구급혈류동역학신식,위림상진단제공방조.
Objective To assess the clinical value of volume helical shuttle (VHS) of highdefinition CT (HDCT) in the diagnosis of congenital heart disease (CHD).Methods Forty-three patients suffering from CHD were examined with VHS of HDCT and echocardiography (ECHO).Twenty-four patients (21 children,3 adults) received surgery.Based on surgical data,the diagnostic accuracy of CHD by VHS of HDCT was compared with that by ECHO with respect to the intra-cardiac lesion,extra-cardiac lesion and hemodynamics.The visibility of the origin and proximal course of coronary arteries was also evaluated on VHS.CT effective doses were calculated,using mSv =DLP × K. Results Thirty-six intra-cardiac deformities were found by operation,and the diagnostic accuracy of both VSH and ECHO were 100.0％ (36/36).VHS successfully detected 42 of 44 (95.4％) cardiac-vascular connection and large vascular deformities,whereas ECHO only detected 26 (59.1％ ).The right-to-left shunt and left-to-right shunt of septal defects revealed by VHS were 5 and 6 patients respectively,which all coincided with the results of ECHO.Fourteen bi-directional shunt of septal defects were detected by ECHO,and 13 of them were diagnosed as right-to-left shunt by HDCT except an illegibility in 1 patient.The origin and proximal course of coronary arteries were all visible on VHS.Effective dose for children was (3.38 ± 1.86) mSv,and for adults was ( 10.27 ± 2.59) mSv.Conclusions VHS of HDCT scan is advantageous in the diagnosis of CHD.It can depict the intra- and extra- cardiac structures as well as coronary arteries and provide hemodynamic information.