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目的探讨CT联合超声心动图对法洛四联症中肺动脉狭窄包括肺动脉内径、右心室流出道内径及肺血管发育的诊断准确性。方法选取2014年7月至2016年12月进行手术治疗的法洛四联症患儿94例,均为单纯法洛四联症。采用单一超声心动图和CT联合超声心动图检测,评估肺动脉狭窄部位及患者肺血管发育状况,与手术后实际诊断结果进行对比分析,比较联合检测及单一检测的方法对肺动脉主干、左右肺动脉内径、右心室流出道内径诊断的准确性。结果与术后的结果比较,单一超声心动图检测对94例法洛四联症患儿肺动脉狭窄部位的诊断准确率为68.09%,漏诊率为31.91%;而超声心动图和CT联合检测的准确率为91.49%,漏诊率仅为8.51%,联合检测对肺动脉狭窄部位的诊断准确率明显高于单一检测(P<0.05)。联合检测对肺动脉主干、左、右肺动脉内径、右心室流出道内径、Me Goon指数、Nakata指数与手术实测结果之间比较差异无统计学意义(P均>0.05);而单一超声心动图检测与手术实际结果之间的各项指标比较,差异均有统计学意义(P均<0.05)。结论 CT与超声心动图联合检测在法洛四联症肺动脉狭窄病变方面的诊断具有重要价值,其诊断准确性高于单一超声心动图检测的诊断准确性。
Objective To investigate the diagnostic accuracy of CT combined with echocardiography in the diagnosis of pulmonary stenosis, including the diameter of pulmonary artery, the diameter of right ventricular outflow tract and the development of pulmonary vessels in patients with tetralogy of Fallot. Methods Ninety-four children with tetralogy of Fallot who underwent surgical treatment from July 2014 to December 2016 were all treated with tetralogy of Fallot. Single echocardiography and CT combined with echocardiography were used to assess pulmonary vascular stenosis and pulmonary vascular development in patients with pulmonary vascular development and postoperative comparative analysis of the actual diagnosis, the combined detection and single detection methods of pulmonary artery, left and right pulmonary artery diameter, Right ventricular outflow tract diameter diagnostic accuracy. Results Compared with postoperative results, the accuracy of single echocardiography in diagnosing pulmonary stenosis in 94 patients with tetralogy of Fallot was 68.09% and the rate of misdiagnosis was 31.91%. The accuracy of echocardiography and CT combined detection was accurate The rate of diagnosis was 91.49% and the rate of misdiagnosis was only 8.51%. The diagnostic accuracy of joint detection for pulmonary stenosis was significantly higher than that of single detection (P <0.05). There was no significant difference between the combined detection of pulmonary artery trunk, left and right pulmonary artery diameter, right ventricular outflow tract diameter, Me Goon index, Nakata index and the measured results (P> 0.05), while the single echocardiography The actual results between the various indicators of surgery, the differences were statistically significant (P all <0.05). Conclusion The combination of CT and echocardiography in the diagnosis of tetralogy of Fallot pulmonary stenosis is of great value. The diagnostic accuracy is higher than that of single echocardiography.