目的探讨多层螺旋CT(MSCT)多维重组技术对肺动脉闭锁(PA)的诊断价值。方法回顾性分析9例肺动脉闭锁(PA)患儿的薄层CT增强扫描资料,将数据传至工作站进行多平面重组(MPR)、容积再现技术(VRT)及最大密度投影(MIP),结合手术与超声心动图(UCG)结果分析PA的影像学特点。结果 9例中PA合并室间隔缺损(VSD)者5例;PA不合并VSD者4例,其中3例右心室发育不良及三尖瓣狭窄或闭锁,1例右心室体积基本正常合并三尖瓣重度反流。UCG对PA检出率为77.8%,2例肺动脉瓣闭锁(PVA)均正确诊断,7例肺动脉干闭锁(PTA)正确诊断2例(28.6%),3例误诊为PVA,2例漏诊。MSCT血管成像(MSCTA)对PA诊断准确率为88.8%,其对2例PVA1例正确诊断,另1例疑诊;对7例PTA均正确诊断。6例PA存在侧支血管,MSCTA均能显示侧支来源、数量、走行及直径,UCG均漏诊,其中1例PDA误诊为侧支血管。结论 MSCT多维重组技术对充分显示PA全貌和伴发的心外血管畸形与体肺侧支循环具有重要的诊断价值,UCG对细小心内畸形及心瓣膜的显示可为MSCT提供补充,两者结合应用对包括手术在内的临床治疗具有重要的指导作用。
Objective To evaluate the diagnostic value of multi-slice CT(MSCT) and multi-dimensional reconstructions for congenital pulmonary atresia(PA).Methods The enhanced thin CT images of 9 patients with PA were retrospectively analyzed.The data were transmitted to the workstation for multi-planar reformation(MPR),volume rendering technique(VRT) and maximum intensity projection(MIP).The CT imaging features of PA were analyzed combining with operation and Ultrasonic Cardiogram(UCG).ResultsIn all cases,5 cases were ...