CAJ | 학술논문

目的：探讨双源 CT （dual‐source CT ，DSCT ）低剂量大螺距技术在婴幼儿完全性肺静脉异位引流（total a‐nomalous pulmonary venous connection ，TAPVC）诊断中的应用价值。方法回顾性分析我院10例TAPVC婴幼儿患者的临床资料，所有患儿术前行前瞻性心电门控下DSCT大螺距血管成像，均经手术治疗证实。由两位放射科医师按4分法对CT图像质量进行主观评价，同时记录辐射剂量。定量数据表示为平均数±标准差，分类数据表示为比例和百分比。观察者之间图像质量主观评分的一致性通过使用Kappa检验进行评估。结果所有患儿的CT图像均为可诊断图像，主观评分为2．7±0．7（2～4分），两位医师的评价一致性好（ k ＝0．79）。10例TAPVC诊断及分型均和手术结果一致，包括心上型6例、心内型2例、心下型2例。平均剂量长度乘积及有效辐射剂量分别为（10．8±4．3）mGy · cm和（0．26±0.08）mSv。结论 DSCT低剂量大螺距技术是一种可靠的诊断婴幼儿 TAPVC的检查方法，能为术前提供很好的参考依据。
목적：탐토쌍원 CT （dual‐source CT ，DSCT ）저제량대라거기술재영유인완전성폐정맥이위인류（total a‐nomalous pulmonary venous connection ，TAPVC）진단중적응용개치。방법회고성분석아원10례TAPVC영유인환자적림상자료，소유환인술전행전첨성심전문공하DSCT대라거혈관성상，균경수술치료증실。유량위방사과의사안4분법대CT도상질량진행주관평개，동시기록복사제량。정량수거표시위평균수±표준차，분류수거표시위비례화백분비。관찰자지간도상질량주관평분적일치성통과사용Kappa검험진행평고。결과소유환인적CT도상균위가진단도상，주관평분위2．7±0．7（2～4분），량위의사적평개일치성호（ k ＝0．79）。10례TAPVC진단급분형균화수술결과일치，포괄심상형6례、심내형2례、심하형2례。평균제량장도승적급유효복사제량분별위（10．8±4．3）mGy · cm화（0．26±0.08）mSv。결론 DSCT저제량대라거기술시일충가고적진단영유인 TAPVC적검사방법，능위술전제공흔호적삼고의거。
Objective To explore the usefulness of high‐pitch dual‐source CT (DSCT ) angiography in the evaluation of total anomalous pulmonary venous connections .Methods Ten patients (mean age:0 .31 ± 0 .27 yrs ,age range:1~8 months ,boy :6) with total anomalous pulmonary venous connections underwent DSCT angiography .The types of total a‐nomalous pulmonary venous connections and the number of pulmonary veins were confirmed by the surgical findings .The subjective image quality was evaluated on a four‐point scale by two radiologists .Radiation dose values were calculated . Quantitative data were expressed as means ± standard deviations and categorical data were given in proportions and per‐centages .Interobserver agreement in subjective image quality grading was assessed by using kappa statistics .Results All images were diagnosable .The average subjective image quality score was 2 .7 ± 0 .7(2~4) .Two radiologists made good a‐greement ( k =0 .79) .In all patients ,CT angiography correctly depicted total anomalous pulmonary venous connections . Six cases were the supracardiac type ,two cases were the cardiac type ,,and two cases were the mixed type .The mean dose‐length product was (10 .8 ± 4 .3) mGy · cm resulting in an estimated mean effective radiation dose of (0 .26 ± 0 .08) mSv .Conclusion DSCT angiography provides high diagnostic accuracy for the preoperative assessment of total anomalous pulmonary venous connections in children .