摘要
目的 探讨低剂量双源CT（DSCT）血管成像在左冠状动脉异常起源于肺动脉（ALCAPA）诊断中的应用价值.方法 回顾性分析山东省医学影像学研究所2008年1月至2012年12月10例ALCAPA患者的临床资料,年龄0.2～15（5±5）岁.所有患者均行DSCT及超声心动图检查,其中7例患儿行手术治疗,4例患儿行血管造影检查.由两位放射科医师对DSCT图像质量进行主观评价,同时记录辐射剂量.结果 DSCT血管成像诊断ALCAPA的准确率100%,其中左冠状动脉开口于肺动脉左前壁1例,左侧壁3例,右侧壁者4例,后壁2例,所有患者右冠状动脉均起自主动脉右冠状窦,其中5例迂曲扩张.所有患儿的DSCT图像均为可诊断图像,主观评分为2～4（3.2±0.8）分,两位医师的评价一致性好（k=0.79）.超声心动图正确诊断7例,1例误诊为扩张型心肌病,1例误诊为左冠状动脉-肺动脉瘘,1例误诊心内膜弹力纤维增生症.CT平均辐射剂量为（0.56±0.28） mSv.结论 低剂量DSCT血管成像可作为一种可靠的诊断ALCAPA的无创影像学方法.
Objective To explore the clinical usefulness of anomalous origin of left coronary artery from the pulmonary artery （ALCAPA） by dual-source CT （DSCT） angiography. Methods A total of 10 patients （ mean age 5.1 ± 5.0 yrs, age range 0. 2 - 15 yrs ; male 5 ） with ALCAPA who underwent DSCT angiography and echocardiography were retrospectively included. Surgery was performed in 7 patients, and conventional cardiac angiography （CCA） in 4 patients. The subjective image quality was evaluated on a four- point scale by two radiologists. Radiation dose values were calculated. Results ALCAPA in all patients were accurately displayed with DSCT with the accuracy of 100%. The left coronary arteries originate from the inferior-left wall of the pulmonary artery in 1 patients, from left lateral wall in 3 patients, from right lateral wall in 4 patients and posterior wall in 2 patients, respectively. In all cases, the origins of the right coronary artery were normal and originated from the right sinus of Valsalva of aorta, the right coronary artery was turtuous and dilated in 5 patients. All DSCT images were diagnosable. The average subjective image quality score was 2 - 4 （ 3.2 ± 0. 8 ）. Two radiologists made good agreement （ k = 0. 79 ）. The ED was （ 0. 56 ± 0. 28） mSv. Seven cases were diagnosed correctly by echocardiography while 3 cases was misdiagnosed as dilated cardiomyopathy, left coronary artery-pulmonary artery fistula and endoeardial fibroelastosis, respectively. Conclusion Low-dose DSCT magiography provides high diagnostic accuracy for the assessment of ALCAPA.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第45期3590-3593,共4页
National Medical Journal of China
基金
山东省优秀中青年科学家科研奖励基金计划（BS2013YY060）
山东省医药卫生科技发展计划（2013WS0180）
