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目的探讨双源计算机断层摄影(dual-source computed tomography,DSCT)诊断先天性心脏病(先心病)的临床应用价值。方法 DSCT增强扫描检查先心病患者20例,年龄4个月~53岁,平均19岁;所有病例均以心脏超声(echocardiography,ECHO)为对照,并经手术证实。结果 20例患者经手术证实的心内外结构畸形共63处,DSCT检出59处,诊断敏感性为93·7%;ECHO检出55处,诊断敏感性87·3%,两种方法诊断敏感性比较差异无统计学意义(χ2=1·474,P=0·225)。63处结构畸形中,心脏部分畸形41处,DSCT检出37处(90·2%),ECHO检出37处(90·2%),两者敏感性相当(P=1·000);心脏-大血管连接处畸形9处,DSCT检出9处(100%),ECHO检出8处(88·9%),差异无统计学意义(P>0·05);大血管部分畸形13处,DSCT检出13处(100%),ECHO检出10处(76·9%),差异无统计学意义(P>0·05)。结论 DSCT能够显示心内外结构畸形,具有较高的诊断敏感性,对先天性心脏病,特别是合并心外大血管畸形的诊断有重要价值。
Objective To investigate the clinical value of dual-source computed tomography (DSCT) in the diagnosis of congenital heart disease (CHD). Methods Twenty patients with congenital heart disease were examined by DSCT. The mean age was 19 years (range, 4 months to 53 years). All cases were confirmed by echocardiography (ECHO) as control. Results Twenty patients were confirmed by surgery. There were 59 DSMs with a sensitivity of 93.7% and ECHO was detected with a sensitivity of 87.3%. Both methods were sensitive to diagnosis The difference was not statistically significant (χ2 = 1.47, P = 0 · 225). Of the 63 structural abnormalities, 41 were malformed in the heart, 37 (90.2%) were detected by DSCT and 37 (90.2%) by ECHO, both of which had similar sensitivities (P = 1000); heart - There were 9 deformities at the large vessel junction, 9 at DSCT (100%) and 8 at ECHO (88.9%), with no significant difference (P> 0.05) , 13 (100%) were detected by DSCT and 10 (76.9%) by ECHO. The difference was not statistically significant (P> 0.05). Conclusions DSCT can show the structural abnormalities of the heart and the outside of the heart and has high diagnostic sensitivity. It is of great value in the diagnosis of congenital heart disease, especially the extravascular malformations.