CAJ | 학술논문

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21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 20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。
목적탐토전자속CT(EBCT)재폐정맥이상련접진단중적림상개치。재료여방법 EBCT진단폐정맥이상련접환자21례，기중남13례，녀8례。년령3～63세，평균15.6세。17례행증강단층용적소묘，4례행증강련속용적소묘。전부병례균행표면음영현시법삼유중건。17례유심혈관조영혹수술결과，기중9례단순행조영，4례단순행수술，4례조영후수술。결과 20례술전자료，EBCT진단위완전형폐정맥이상련접12례，부분형폐정맥이상련접8례。전자포괄심상형3례，심장형8례화혼합형1례。EBCT균청석현시이상련접폐정맥적수목、분포화위치。1례술후복사병례，EBCT시문합구협착。7례완전형폐정맥이상련접자，EBCT제시합병내장심방이위종합정。8례유수술대조자，EBCT대폐정맥이상련접적정성、정위진단전부정학。결론 EBCT급기삼유중건가준학현시이상련접폐정맥적위치、수목화술후협착，대명학흉복병발기형유명현우세，시일충중요적무창성진단폐정맥이상련접적방법。
Objective　To investigate the clinical usefulness of electron beam computed tomography (EBCT) in the diagnosis of anomalous pulmonary venous connection.　Materials and Methods　Anomalous pulmonary venous connection was diagnosed with EBCT in 21 patients, including 13 males and 8 females and aged 3～63 years (mean 15.6 years). Contrast-enhanced single-slice scanning was performed in 17 patients, and contrast-enhanced continuos volume scanning in 4 patients. Shaded surface display was done for 3D reconstruction in all patients. Both angiocardiographic and operative outcomes were obtained in 4 patients, while only angiocardiographic results in 9, only operative results in 4.　Results　Of the 20 patients received EBCT before operation, partial anomalous pulmonary venous connection was diagnosed in 8, and total anomalous pulmonary venous connection in 12, including supracardiac type (n=3), cardiac type (n=8) and mixed type (n=1). EBCT clearly displayed the number, distribution and location of anomalous pulmonary venous connection in all patients. The diagnosis by EBCT was compatible with the operative results in all the 8 patients receiving surgery. EBCT revealed a stenosis of anastomotic stoma in 1 patient after surgery, as well as the syndrome of visceroatrial heterotaxia in 7 patients with total anomalous pulmonary venous connection. 　Conclusion　EBCT with 3D reconstruction can detect not only the number, distribution, connective location and postoperative stenosis of anomalous pulmonary venous connection, but also the thoracic and abdominal complicated lesions such as the syndrome of visceroatrial heterotaxia. It is a noninvasive method with high accuracy for the diagnosis of anomalous pulmonary venous connection.