64层CT血管造影对主动脉弓离断的诊断价值

摘要

Objective; To evaluate the value of multi- slice spiral CT angiography ( MSCTA) in the diagnosis of interrupted aortic arch (IAA) . Methods; Seven IAA pediatric patients with CT angiography were retrospectively analyzed, and their types were judged and correlated with the surgery findings. The length of the aortic vascular defect, caliber of the thoracic aorta proximal and distal to the interruption were measured respectively in images of maximum intensity projection and volume rendering, and the differences were contrasted. Results; Seven IAA of 910 pediatric patients with congenital heart disease were found, in which 5 type A and 2 type B were included. Thestatistical analysis showed no significant differences in measuring the length of the aortic vascular defect and caliberof the thoracic aorta proximal[ (17. 37 ±4. 47), (20. 24 ±6. 63)mm,P =0. 18; (8. 42 ±3. 54) , (9. 21 ±4. 05) mm, P - 0. 13 respectively]. There were slightly differences in judging the distal diameter [ (8. 42 ±2. 22) , (9. 61 ± 2. 58)mm,P =0. 03). Conclusion; MSCTA is a valuable technique for defining the exact type of IAA, length of the aortic vascular defect and caliber of the thoracic aorta proximal and distal to the interruption, which provided ample evidence for surgical operation.%目的:探讨64层螺旋CT血管造影在主动脉弓离断中的诊断价值.方法:回顾性分析7例主动脉弓离断患儿的CT资料,判断其类型,并与手术结果进行对比;分别在容积重建及最大密度投影图像上测量离断的距离、离断近端及远端血管的直径,对比其差异.结果:本组910例先天性心脏病患儿中,共诊断主动脉弓离断 7例(占0.77%),其中A型5例,B型2例;容积重建及最大密度投影测量离断的长度及离断近端血管直径差异无统计学意义[分别为(17.37±4.47)、(20.24±6.63)mm,P=0.18;(8.42±3.54)、(9.21±4.05)mm,P=0.13].容积重建及最大密度投影测量离断远端血管直径差异有统计学意义[(8.42±2.22)、(9.61±2.58)mm,P=0.03].结论:64层螺旋CT及后处理技术可满意地诊断主动脉弓离断,判断其类型,并可以精确地测量离断的长度及离断处远、近端的血管直径,为手术计划的制定提供充足的依据.