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目的研究64层CT心电门控与非门控扫描技术对复杂先天性心脏病(CHD)患儿冠状动脉(CA)的显示价值。方法对31例复杂CHD患儿进行64层CT检查,其中20例患儿同时进行心电门控及非心电门控扫描,按5级评分法分别观察两种扫描模式下冠状动脉各节段的成像质量。结果与非心电门控扫描相比,所有心电门控扫描模式均优于非门控模式。除旋支近段、右冠状动脉近段、远段成像质量无明显差异外,余各节段成像质量差异均有统计学意义。两种扫描模式对CA近段的观察差异无统计学意义,CA远段的观察差异有统计学意义。结论非门控扫描能较好地观察CA的开口及近段的走行,能满足绝大部分临床术前诊断需要,可作为复杂CHD推荐扫描模式。该扫描模式下可疑CA异常开口、走行时需加扫心电门控模式,从而进一步显示CA的细节。对于临床高度关注CA位置的病例应常规进行心电门控扫描。
Objective To investigate the value of 64-slice CT coronary angiography and non-portal scanning in the diagnosis of coronary artery (CA) in children with complex congenital heart disease (CHD). Methods Totally 31 patients with complicated CHD were examined by 64-slice CT. Among them, 20 children underwent both ECG gating and non-ECG gating scanning. The coronary artery segments The image quality. Results All ECG gated scanning modes outperformed non-gated modes compared to non-ECG gated scans. In addition to the proximal branch of spinous process, proximal coronary artery, distal segment imaging quality was no significant difference, the remaining segments of the imaging quality differences were statistically significant. There was no significant difference between the two scan modes in the observation of proximal CA, and the difference in CA distal section was statistically significant. Conclusion Non-gated scans can better observe the opening of CA and the proximal segment, which can meet the needs of most clinical preoperative diagnosis and can be used as the recommended scanning mode for complex CHD. Suspicious CA anomaly in the scan mode openings, walking need to be added to sweep the heart gated mode, which further shows the details of CA. ECG-gated scans should be routinely performed for patients with clinically significant CA locations.