摘要
目的探讨新型宽探测器CT联合70kV低管电压、前瞻心电门控技术对婴幼儿先天性心脏病诊断的临床应用价值。方法采用Revolution CT联合70kV低管电压前瞻心电门控扫描技术对临床拟诊为复杂性先天性心脏病的婴幼儿45例进行心脏CTA检查,对图像质量进行评分。以手术结果为金标准,比较心脏CTA和心脏超声的诊断效能。记录并计算患儿接受的有效辐射剂量及碘对比剂用量。结果 45例患儿共25种独立的心血管畸形,包括6种心内结构异常和19种心外大血管畸形。对于先天性心外大血管畸形,心脏CTA的诊断准确率和检出率[99.77%(853/855),97.73%(86/88)]均高于心脏超声[98.71%(844/855),88.64%(78/88);χ~2=6.28、5.72,P均<0.05)]。有效辐射剂量为(0.20±0.05)mSv,碘对比剂用量为(2.06±1.09)g。45例患儿的图像质量均满足影像诊断要求。结论新型宽探测器CT联合70kV管电压和前瞻性心电门控技术在降低辐射剂量和碘对比剂用量的同时,能获得良好的图像质量和诊断效能,对诊断婴幼儿复杂性先天性心脏病具有重要的临床价值。
Objective To investigate the value of wide-detector Revolution CTA with 70 kV tube voltage and prospective ECG-gated technique in diagnosis of congenital heart disease （CHD） in infants and children. Methods Forty-five infants and children with complicated CHD underwent echocardiography and wide-detector Revolution CTA. According to the surgical findings, the diagnostic efficiency of Revolution CTA and echocardiography were calculated and compared. The radiation effective dose （ED） and iodine dose were calculated. The quality of CT images was also evaluated. Results There were 25 separate cardiovascular anomalies including 6 congenital cardiac structure anomalies and 19 congenital extracardiac vascular anomalies. For congenital extracardiac vascular anomalies, there was significant difference of diagnostic accuracy and the detectable rate between CTA （99.77%[853/855], 97.73%[86/88]） and echocardiography （98.71%[844/855], 88.64%[78/88]; χ^2=6.28, 5.72, both P〈0.05）. The average of ED was （0.20±0.05）mSv and the mean iodine dose was （2.06±1.09）g. All CT images were qualified for diagnosis. Conclusion The wide-detector Revolution CTA, with the prospective ECG-gated technique and 70 kV tube voltage, can provide high accuracy for assessment of CHD in infants and children, which can keep good image quality, with the low radiation dose.
出处
《中国医学影像技术》
CSCD
北大核心
2017年第4期594-598,共5页
Chinese Journal of Medical Imaging Technology
