CAJ | 학술논문

目的：：通过与实时三维超声心动图(RT-3DE)的对比，探讨64层螺旋CT(64SCT)冠状动脉成像诊断川崎病患儿冠状动脉病变( CAL)的临床应用价值。方法：选择2012年9月至2014年8月我院收治的川崎病患儿30例，男性18例，女性12例。发病年龄6个月~10岁，平均年龄(2.0±1.5)岁，均于发病11 d内给予64SCT及RT-3DE检查，观察冠状动脉开口、各支的形态和走向，并测量其内径。结果：64SCT检查结果示CAL13例，累及冠状动脉18支，其中累及左冠状动脉主干13支，左前降支1支，左回旋支1支，右冠状动脉3支。 RT-3DE检出7例，累及冠脉9支，其中左冠状动脉主干6支，右冠状动脉2支，右冠脉瘤1支。两种检查方法探查左右冠状动脉病变无显著性差异(P>0.05)。结论：利用64SCT能观察冠脉的全貌，特别是冠脉的中远段，对CAL显示远高于RT-3DE。64SCT用于探查小儿KD冠脉损害是可行的，可以作为心脏超声的补充和替代方法，对KD急性期冠脉损伤诊断具有重要的意义。
목적：：통과여실시삼유초성심동도(RT-3DE)적대비，탐토64층라선CT(64SCT)관상동맥성상진단천기병환인관상동맥병변( CAL)적림상응용개치。방법：선택2012년9월지2014년8월아원수치적천기병환인30례，남성18례，녀성12례。발병년령6개월~10세，평균년령(2.0±1.5)세，균우발병11 d내급여64SCT급RT-3DE검사，관찰관상동맥개구、각지적형태화주향，병측량기내경。결과：64SCT검사결과시CAL13례，루급관상동맥18지，기중루급좌관상동맥주간13지，좌전강지1지，좌회선지1지，우관상동맥3지。 RT-3DE검출7례，루급관맥9지，기중좌관상동맥주간6지，우관상동맥2지，우관맥류1지。량충검사방법탐사좌우관상동맥병변무현저성차이(P>0.05)。결론：이용64SCT능관찰관맥적전모，특별시관맥적중원단，대CAL현시원고우RT-3DE。64SCT용우탐사소인KD관맥손해시가행적，가이작위심장초성적보충화체대방법，대KD급성기관맥손상진단구유중요적의의。
Objective: To investigate the clinical value of 64-slice computed tomography coronary angiography for Kawasaki Disease with coronary artery lesion and perform comparison with Real-Time Three-Dimensional Echocardiography. Methods:From Sep. 2012 to Aug. 2014,30 patients with Kawasaki Disease,including 18 males and 12 females,aged 6 months to 10 years,mean age (2. 0 ± 1. 5) years,were enrolled in the study. All patients received Real-Time Three-Dimensional Echocardiography ( RT-3DE) and 64-slice computed tomography detection to observe the coronary. Results:64SCT showed the number of coronary artery lesion was 13cases invol-ving 18coronary arteries,among which there was 13 Left main,1 left anterior descending artery,1 left circumflex artery and 3 right coro-nary artery. RT-3DE showed that the number of coronary artery lesion was 7 cases involving 9 coronary arteries,among which there was 6 left main,2 right coronary artery and 1 right coronary artery aneurysms. There was no significant difference between the two methods (P>0. 05). Conclusion:Use 64SCT can observe the whole picture of coronary,especially in the distal of coronary. The CAL displa-ying is much higher than RT-3DE. 64SCT for probing coronary artery damage in children with KD is feasible;it can be used as comple-mentary and alternative methods of cardiac ultrasound. It has an important significance for the diagnosis of Kawasaki disease coronary artery.