摘要
目的通过近两年来积累的河南省胸科医院小儿先心完全大动脉转位并冠脉异常病例,对先心完全大动脉转位(TGA)并冠脉异常进行探讨性研究。方法使用SIMENSE双源256排CT的心电门控(electricardiography gating,ECG-gating)对小儿先心患者进行心脏血管造影扫描CT(CTA),同时观察患儿心率,难以配合的小儿患者需在全麻下进行检查,对检查结果回进行顾性分析。通过对河南省胸科医院近两年来的25例小儿先心的CTA影像并结合选择性心导管造影和超声心动结果,总结小儿先心完全性大动脉转位(TGA)并冠脉异常的类型以及冠脉起源,开口,数量,走行,分布异常等,心脏外科术后,与超声心动(UCG),选择性心导管造影(CCG)比较,验证其符合情况和CTA检查优势。结果本组25例患者CTA结果示:主动脉-肺动脉位置关系为:右前-左后的8例,左前-右后13例;前-后排列的4例。冠脉情况:右冠开口于右后或右前冠状动脉窦,左冠开口于左后冠窦或左前冠窦共21例;单冠脉畸形并开口左冠状动脉窦的1例;左冠状动脉或右冠状动脉开口位于升主动脉的3例。25例患者中,可见2例左冠状动脉前降支狭窄;DSCT和UCG诊断准确率分别为100%和77%,与CCG结果无差别。结论完全大动脉转位常伴随冠脉异常;DSCT在诊断先心完全性大动脉转位并冠脉异常方面优于UCG;与CCG无差异,具有重要的临床意义。
Objective To study complate transposition of great artery accompany coronary abnormal.Methods By SIMENS 256 rows dural source CT,using ECG-gating angiography,meanwhile,observing heart rate,anesthesia for noncooperation,retrospectively analyze 25 infant congenital heart diseases(CHD)in He Nan Province Chest Hospital,summarize infant TGA accompany coronary abnormal,include origine,opening,number,walking-line,distribution,etc.Comparing with Ultrasound Cardiagram(UCG),Cardic Cathetergraphy(CCG).Proved the coincidence rate by surgery.Results In 25 cases:Aorte-Pulmary Artery relationship shows:8 cases are rightoantior-leftopostior,13 cases are lefto-anteri-rightopostior,4 cases are antiopostior.Coronary opening:Pr2R or Ar2R,Pl1LAD,Cx or Al1LAD,Cx,total 21 cases;1LAD,Cx;R,only one;3 cases open in ascending aortic wall.In 25 cases:2 cases have coronal stenosis,Comparing with UCG,The cioncidence rate:DSCT 100%,same as CCG,UCG 77%.Conclusion DSCT is as same as CCG and better than UCG.
作者
文强
WEN Qiang(Imaging Department of Henan Province Chest Hospital,Zhengzhou 450000,China)
出处
《医药论坛杂志》
2020年第12期95-98,共4页
Journal of Medical Forum
关键词
先心
完全性大动脉转位
冠脉异常
双源CT
心电门控CTA
超声心动
选择性心导管造影
Congenital heart disease(CHD)
Complate transposition of great artery(TGA)
Dural source CT(DSCT)
ECG-gating CTA
Ultrosound cardiogram(UCG)
CCG
