中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2013年
8期
739-744
,共6页
张晓凡%曾立红%王志伟%王芳
張曉凡%曾立紅%王誌偉%王芳
장효범%증립홍%왕지위%왕방
心脏缺损,先天性%体层摄影术,X线计算机%儿童%婴儿%辐射剂量
心髒缺損,先天性%體層攝影術,X線計算機%兒童%嬰兒%輻射劑量
심장결손,선천성%체층섭영술,X선계산궤%인동%영인%복사제량
Heart defects,congenital%Tomography,X-ray computed%Child%Infant%Radiation dosage
目的 探讨128层CTA前门控技术在小儿复杂先天性心脏病(CHD)诊断中的价值.方法 选取复杂CHD患儿80例,根据就诊时间先后分别采用后、前门控技术行128层CTA检查,每组各40例,所有患儿在CTA检查前1周内均行心脏超声心动图(UCG)检查.采用独立样本t检验和x2检验对图像的有效辐射剂量和质量进行统计分析；以手术结果为诊断标准,采用x2检验将术前CTA前、后门控扫描组与UCG诊断结果进行对照研究.结果 前门控组的有效辐射剂量[(1.00±0.26) mSv]较后门控组[(7.37±0.52) mSv]降低了86％,差异有统计学意义(t=69.296,P＜0.01).图像质量评估前、后门控2组:0级均为0例,1级分别为2和0例,2级分别为8和1例,3级分别为30和39例,2组间差异无统计学意义(x2 =0.044,P＞0.05).前、后门控组CTA在心外大血管畸形诊断符合率分别为98.3％ (59/60)和98.3％ (58/59),明显优于UCG[分别为76.7％ (46/60)、76.7％(45/59)],差异有统计学意义(x2值分别为13.144、12.644,P值均＜0.01),但前、后门控组间差异无统计学意义(x2=0.001,P＞0.05).前、后门控组CTA对心脏大血管连接异常诊断符合率均为100.0％,与UCG[分别为97.2％(35/36)、97.3％ (36/37)]比较,差异无统计学意义(x2值分别为1.014、0.001,P值均＞0.05).前、后门控组CTA对心内畸形诊断符合率分别为88.7％ (47/53)和92.5％ (49/53),与UCG[分别为98.1％ (52/53)、98.1％ (52/53)]比较,差异无统计学意义(x2值分别为3.824、1.889,P值均＞0.05),前、后门控组间差异也无统计学意义(x2=0.442,P＞0.05).同时,MSCTA能观察所有患儿肺部情况,前、后门控2组共检出合并气道异常9例.结论 128层CTA前门控技术在小儿复杂CHD术前诊断中具有很高的临床应用价值,有助于手术方案的制定和手术风险的评估.
目的 探討128層CTA前門控技術在小兒複雜先天性心髒病(CHD)診斷中的價值.方法 選取複雜CHD患兒80例,根據就診時間先後分彆採用後、前門控技術行128層CTA檢查,每組各40例,所有患兒在CTA檢查前1週內均行心髒超聲心動圖(UCG)檢查.採用獨立樣本t檢驗和x2檢驗對圖像的有效輻射劑量和質量進行統計分析；以手術結果為診斷標準,採用x2檢驗將術前CTA前、後門控掃描組與UCG診斷結果進行對照研究.結果 前門控組的有效輻射劑量[(1.00±0.26) mSv]較後門控組[(7.37±0.52) mSv]降低瞭86％,差異有統計學意義(t=69.296,P＜0.01).圖像質量評估前、後門控2組:0級均為0例,1級分彆為2和0例,2級分彆為8和1例,3級分彆為30和39例,2組間差異無統計學意義(x2 =0.044,P＞0.05).前、後門控組CTA在心外大血管畸形診斷符閤率分彆為98.3％ (59/60)和98.3％ (58/59),明顯優于UCG[分彆為76.7％ (46/60)、76.7％(45/59)],差異有統計學意義(x2值分彆為13.144、12.644,P值均＜0.01),但前、後門控組間差異無統計學意義(x2=0.001,P＞0.05).前、後門控組CTA對心髒大血管連接異常診斷符閤率均為100.0％,與UCG[分彆為97.2％(35/36)、97.3％ (36/37)]比較,差異無統計學意義(x2值分彆為1.014、0.001,P值均＞0.05).前、後門控組CTA對心內畸形診斷符閤率分彆為88.7％ (47/53)和92.5％ (49/53),與UCG[分彆為98.1％ (52/53)、98.1％ (52/53)]比較,差異無統計學意義(x2值分彆為3.824、1.889,P值均＞0.05),前、後門控組間差異也無統計學意義(x2=0.442,P＞0.05).同時,MSCTA能觀察所有患兒肺部情況,前、後門控2組共檢齣閤併氣道異常9例.結論 128層CTA前門控技術在小兒複雜CHD術前診斷中具有很高的臨床應用價值,有助于手術方案的製定和手術風險的評估.
목적 탐토128층CTA전문공기술재소인복잡선천성심장병(CHD)진단중적개치.방법 선취복잡CHD환인80례,근거취진시간선후분별채용후、전문공기술행128층CTA검사,매조각40례,소유환인재CTA검사전1주내균행심장초성심동도(UCG)검사.채용독립양본t검험화x2검험대도상적유효복사제량화질량진행통계분석；이수술결과위진단표준,채용x2검험장술전CTA전、후문공소묘조여UCG진단결과진행대조연구.결과 전문공조적유효복사제량[(1.00±0.26) mSv]교후문공조[(7.37±0.52) mSv]강저료86％,차이유통계학의의(t=69.296,P＜0.01).도상질량평고전、후문공2조:0급균위0례,1급분별위2화0례,2급분별위8화1례,3급분별위30화39례,2조간차이무통계학의의(x2 =0.044,P＞0.05).전、후문공조CTA재심외대혈관기형진단부합솔분별위98.3％ (59/60)화98.3％ (58/59),명현우우UCG[분별위76.7％ (46/60)、76.7％(45/59)],차이유통계학의의(x2치분별위13.144、12.644,P치균＜0.01),단전、후문공조간차이무통계학의의(x2=0.001,P＞0.05).전、후문공조CTA대심장대혈관련접이상진단부합솔균위100.0％,여UCG[분별위97.2％(35/36)、97.3％ (36/37)]비교,차이무통계학의의(x2치분별위1.014、0.001,P치균＞0.05).전、후문공조CTA대심내기형진단부합솔분별위88.7％ (47/53)화92.5％ (49/53),여UCG[분별위98.1％ (52/53)、98.1％ (52/53)]비교,차이무통계학의의(x2치분별위3.824、1.889,P치균＞0.05),전、후문공조간차이야무통계학의의(x2=0.442,P＞0.05).동시,MSCTA능관찰소유환인폐부정황,전、후문공2조공검출합병기도이상9례.결론 128층CTA전문공기술재소인복잡CHD술전진단중구유흔고적림상응용개치,유조우수술방안적제정화수술풍험적평고.
Objective To evaluate the prospective electrocardiograph (ECG)-gated 128-slice spiral CT angiography in the diagnosis of complex congenital heart disease and airway abnormality in children.Methods Eighty children with congenital heart disease received prospective (n =40) or retrospective ECG-gated 128-slice spiral CT angiography (n =40).All of the patients underwent ultrasound cardiogram (UCG) within one week before CTA exmination.The image quality and the effective radiation dose were statistically analyzed using independent samples t test and x2 test.The surgical results were taken as the diagnostic standards,and the preoperative prospective and retrospective CT angiography data were compared with UCG results using x2 test.Results The effective dose of prospective ECG-gated CT angiography[(1.00 ± 0.26)mSv] was reduced by 86％ as compared with the retrospective ECG-gated CT angiography[(7.37 ± 0.52) mSv] (t =69.296,P ＜ 0.01).Image quality was graded 0 in none patients,graded 1 in 2 patients who underwent prospective ECG-gated CT angiography,graded 2 in 8 and 1 patient who received prospective and retrospective ECG-gated CT angiography respectively,and graded 3 in 30 and 39 patients who underwent prospective and retrospective ECG-gated CT angiography,respectively.There was no significant difference in image quality between prospective and retrospective ECG-gated CT angiography (x2 =0.044,P ＞ 0.05).The definitive diagnosis of extracardiac vascular anomalies was made in 98.3％(59/60) of patients by using prospective and retrospective ECG-gated CT angiography,which were significantly superior to UCG results[(76.7％ (46/60),76.7％ (45/59),respectively] (x2 =13.144,12.644,P ＜ 0.01),and there was no significant difference in the definitive diagnosis between prospective and retrospective ECG-gated CT angiography (x2 =0.001,P ＞ 0.05).The definitive diagnosis of the cardiac/large-vessel malformations was made in 100％ of the patients by both prospective and retrospective ECG-gated CT angiography,and there was no significant difference between 128-slice spiral CT angiography results and UCG results [97.2％ (35/36),97.3％ (36/37),respectively] (x2 =1.014,0.001,P ＞0.05).In the cardiac malformations,the definitive diagnosis by prospective and retrospective ECG-gated CT angiography was 88.7 ％ (47/53) and 92.5 ％ (49/53),and there was no significant difference between 128-slice spiral CT angiography results and UCG results [98.1％ (52/53),98.1％ (52/53),respectively](x2 =3.824,1.889,P ＞ 0.05),and no significant difference in the definitive diagnosis was observed between prospective and retrospective ECG-gated CT angiography (x2 =0.442,P ＞ 0.05).In addition,the 128-slice spiral CT angiography detected airway abnormality in 9 cases who underwent prospective or retrospective ECG-gated CT angiography.Conclusion The prospective ECG-gated 128-slice spiral CT angiography exhibits great application value in the preoperative diagnosis of complex congenital heart disease,which helps to develop surgical program and evaluate surgical risks.
