本文選題：先天性心臟病 + 氣管軟化�。� 參考：《第二軍醫(yī)大學(xué)學(xué)報》2017年02期

【摘要】：目的 探討容積螺旋穿梭技術(shù)(VHS)在先天性心臟病伴氣管軟化診斷中的價值。方法 回顧性分析上海交通大學(xué)醫(yī)學(xué)院附屬上海兒童醫(yī)學(xué)中心2014年10月至2016年8月同時行纖維支氣管鏡和VHS CT增強掃描的26例患兒臨床資料,男16例,女10例。按照纖維支氣管鏡結(jié)果將患兒分為氣管軟化組(n=7)和非氣管軟化組(n=19)。通過容積重建、最大密度投影重建技術(shù)觀察評估心內(nèi)結(jié)構(gòu)、心外大血管解剖,利用最小密度投影技術(shù)觀察評估氣管支氣管樹解剖結(jié)構(gòu)。利用Mimics 17.0軟件對各患兒不同呼吸期相的CT圖像進行自動氣管分割并測量不同呼吸期相的氣管橫截面積。以纖維支氣管鏡及手術(shù)結(jié)果為金標(biāo)準(zhǔn),計算VHS CT增強在先天性心臟病的診斷準(zhǔn)確性和氣管軟化的診斷敏感度、特異度和準(zhǔn)確度。結(jié)果 氣管軟化組氣管塌陷面積百分比與非氣管軟化組的氣管塌陷面積百分比差異有統(tǒng)計學(xué)意義(34.23%~74.95%vs 13.73%~78.87%,P=0.02)。VHS CT增強在診斷氣管軟化的敏感度、特異度和準(zhǔn)確度分別為85.71%(6/7)、84.21%(16/19)和84.62%(22/26),而在先天性心臟病診斷中心內(nèi)結(jié)構(gòu)和心外大血管結(jié)構(gòu)的準(zhǔn)確度分別是91.67%(11/12)和100%(12/12)。結(jié)論 VHS CT作為一種新的掃描方式,一次掃描可同時評估先天性心臟病和氣管軟化情況,可以作為一種一站式診斷先天性心臟病伴氣管軟化的檢查方法。
[Abstract]:Objective to evaluate the value of volumetric spiral shuttle technique (VHS) in the diagnosis of congenital heart disease with tracheomalacia. Methods from October 2014 to August 2016, 26 children (16 males and 10 females) with bronchofiberscope and VHS CT enhanced scanning were retrospectively analyzed in Shanghai Children's Medical Center, affiliated to Shanghai Jiaotong University Medical College. According to the results of fiberoptic bronchoscopy, the children were divided into tracheomalacia group (n = 7) and non tracheomalacia group (n = 19). The intracardiac structure was observed and evaluated by volume reconstruction and maximum density projection technique. The anatomical structure of tracheobronchial tree was evaluated by minimal density projection technique. Mimics 17.0 software was used to segment the trachea and measure the trachea cross-sectional area in different respiratory phases. The diagnostic accuracy of VHS CT in congenital heart disease and the diagnostic sensitivity specificity and accuracy of tracheomalacia were calculated according to fiberoptic bronchoscopy and surgical results. Results there was significant difference in the percentage of trachea collapse area between the tracheomalacia group and the non-tracheomalacia group. There was a significant difference in the percentage of trachea collapse area between the tracheomalacia group and the non-tracheomalacia group. The specificity and accuracy were 85.71 / 84.21 / 16 / 19 and 84.62 / 22 / 26, respectively, and the accuracy of the structure in the diagnosis center for congenital heart disease and the extracardiac macrovascular structure were 91.67 / 11 / 12 and 100 / 12, respectively. Conclusion as a new scanning method, VHS CT can be used to evaluate both congenital heart disease and tracheomalacia at the same time, and can be used as a one-stop method for diagnosing congenital heart disease with tracheomalacia.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬上海兒童醫(yī)學(xué)中心影像診斷中心;上海交通大學(xué)醫(yī)學(xué)院附屬上海兒童醫(yī)學(xué)中心呼吸科;通用電氣醫(yī)療集團CT影像研究中心;
【分類號】：R725.411

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