CAJ | 학술논문

目的：采用超声心动图结合Flash CT对部分性肺静脉畸形引流（PAPVC）患者行术前检查，并与手术结果对照，评价超声心动图结合Flash CT对PAPVC的诊断价值。资料与方法收集28例PAPVC患者，术前均行超声心动图及Flash CT大螺距扫描检查，观察PAPVC的类型、房间隔缺损的大小及合并其他畸形，并与手术结果进行对照。结果28例患者中，超声确诊16例，提示可疑5例（其中4例证实为PAPVC，超声诊断正确；1例为肺静脉栓塞，超声误诊），漏诊6例，误诊1例；CT误诊1例；超声诊断准确率（71.4%，20/28）低于CT（96.4%，27/28）（P<0.05）；28例患者合并畸形共44处，超声确诊43处，漏诊1处；CT确诊34处，误诊2处，漏诊8处。超声诊断准确率（97.7%，43/44）高于CT（77.3%，34/44）（P<0.05）。28例平均剂量长度乘积为（15.5±3.2）mGy · cm，平均有效剂量为（0.354±0.058） mSv。结论 Flash CT对PAPVC的诊断准确率较超声心动图高，但对合并心内畸形的诊断准确率低于超声心动图，而且超声可以对瓣膜病变、肺动脉压力及心功能做出全面评价，两者联合应用可以提高术前诊断准确率。
목적：채용초성심동도결합Flash CT대부분성폐정맥기형인류（PAPVC）환자행술전검사，병여수술결과대조，평개초성심동도결합Flash CT대PAPVC적진단개치。자료여방법수집28례PAPVC환자，술전균행초성심동도급Flash CT대라거소묘검사，관찰PAPVC적류형、방간격결손적대소급합병기타기형，병여수술결과진행대조。결과28례환자중，초성학진16례，제시가의5례（기중4예증실위PAPVC，초성진단정학；1례위폐정맥전새，초성오진），루진6례，오진1례；CT오진1례；초성진단준학솔（71.4%，20/28）저우CT（96.4%，27/28）（P<0.05）；28례환자합병기형공44처，초성학진43처，루진1처；CT학진34처，오진2처，루진8처。초성진단준학솔（97.7%，43/44）고우CT（77.3%，34/44）（P<0.05）。28례평균제량장도승적위（15.5±3.2）mGy · cm，평균유효제량위（0.354±0.058） mSv。결론 Flash CT대PAPVC적진단준학솔교초성심동도고，단대합병심내기형적진단준학솔저우초성심동도，이차초성가이대판막병변、폐동맥압력급심공능주출전면평개，량자연합응용가이제고술전진단준학솔。
PurposeTo investigate clinical significance of echocardiography combined with Flash CT in diagnosis of partial anomalous pulmonary venous connection (PAPVC). Materials and Methods Twenty-eight cases of PAPVC were recruited in the study. All the subjects underwent both preoperative echocardiography and coarse pitch Flash CT scanning. Imaging findings were compared with the results of surgery, including the type of PAPVC, size of atrial septal defect (ASD), and other combined malformations. Results Among 28 patients, 16 cases and 5 suspicious cases (4 cases of PAPVC and 1 case of pulmonary vein embolism) were diagnosed by echocardiography. Six cases were missed, and 1 case was misdiagnosed. CT misdiagnosed 1 case. The accurate diagnosis rate of echocardiography (71.4%, 20/28) was lower than that of Flash CT (96.4%, 27/28) (P<0.05). There were 44 combined malformations in 28 cases, 43 lesions were diagnosed by echocardiography, and 34 lesions were diagnosed by Flash CT. The accurate diagnosis rate of echocardiography (97.7%, 43/44) was higher than that of Flash CT (77.3%, 34/44) (P<0.05). The average DLP was (15.5±3.2) mGy·cm and average effective dose (ED) was (0.354±0.058) mSv.Conclusion Flash CT has a higher diagnosis accuracy of PAPVC but a lower diagnostic accuracy of combined malformations when compared with echocardiography. Moreover, echocardiography can make comprehensive evaluation in valve disease, pulmonary artery pressure and cardiac function. Flash CT combined with echocardiography may improve preoperative diagnosis.