256层螺旋CT在心脏室壁瘤中的诊断价值

摘要

目的：探讨256层螺旋CT（MSCT）在左心室室壁瘤(LVA)诊断中的临床应用价值。方法选择2010年2月至2013年7月间我院心胸外科收治的经手术确诊为LVA的患者36例，术前均行MSCT心脏检查和实时三平面超声心动图(RT-3PE)，MSCT扫描后通过EBW工作站后处理（VR、MPR）和动态电影播放模式观察病变，对MSCT、RT-3PE等临床资料进行回顾性分析。结果病变分布在心尖部27例、前壁6例、下壁3例。MSCT表现为收缩期囊袋状膨突，室壁瘤处局部运动消失或呈矛盾运动，造影剂排空延迟，病变处心肌壁变薄，内壁光滑。术前MSCT诊断正确率为97.22%，与RT-3PE的94.44%比较差异无统计学意义（P>0.05）。结论256层螺旋CT诊断LVA安全简便，诊断准确性高，可作为左心室室壁瘤影像学检查的重要手段之一。%Objective To study the clinical application value of 256-slice spiral CT (MSCT) in left ventricu-lar aneurysm (LVA). Methods Thirty-six patients with LVA were confirmed by surgery in our hospital from Feb. 2010 to Jul. 2013, and they were given MSCT and real time three plane echocardiography (RT-3 PE) before operation. All data were post-processed (VR and MPR) in EBW workstation, and the pathological changes were observed by dy-namic movie playback mode. MSCT, RT-3 PE and other clinical data were retrospectively analyzed. Results The le-sions of 27 cases were distributed in the apex, 6 cases in anterior wall and 3 cases in lower wall. MSCT findings were systolic pouch bulging, the local movement were disappeared or contradictory movement in ventricular aneurysm, con-trast emptying was delayed, myocardial wall was thinned and smooth of inwall in lesion. The diagnostic accuracy of MSCT was 97.22%before operation, which showed no statistically significant difference with 94.44%of the RT-3 PE (P>0.05). Conclusion The diagnosis of 256-slice spiral CT in LVA is safe and simple, with high diagnostic accuracy. It is one of the important imaging examination means for left ventricular aneurysm.