本文關(guān)鍵詞： 64層螺旋CT 順序分段分析 全心畸形 先天性心臟病 超聲心　出處：《廣西醫(yī)科大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的通過(guò)應(yīng)用順序分段分析法分析全心畸形類先天性心臟病的64層螺旋CT圖像,探討順序分段分析法在MSCT診斷此類先心病中的臨床應(yīng)用價(jià)值。 方法分析98例行64層螺旋CT和超聲心動(dòng)圖檢查并經(jīng)手術(shù)證實(shí)為全心畸形類先天性心臟病患者的資料。其中男63例,女35例,年齡1個(gè)月—47歲,平均年齡10.07±9.78歲；所有病例均經(jīng)GE lightspeed VCT 64層螺旋CT行平掃及團(tuán)注增強(qiáng)掃描,增強(qiáng)時(shí)使用團(tuán)注造影劑追蹤技術(shù),獲取圖像傳入ADW4.4后處理工作站,使用多平面重組(MPR)、最大密度投影(MIP)和容積再現(xiàn)(VR)等重建方法進(jìn)行分析,觀察的心臟大血管位置、形態(tài)改變及合并的心血管畸形征象,按順序分段分析診斷法進(jìn)行分段分析,列出相應(yīng)節(jié)段的形態(tài)學(xué)畸形改變?nèi)缓髤R集統(tǒng)計(jì),最后與相應(yīng)超聲心動(dòng)圖檢查、手術(shù)結(jié)果進(jìn)行綜合比較。 結(jié)果(1)64層螺旋CT對(duì)全心畸形類先天性心臟病的形態(tài)學(xué)畸形的顯示：心房段畸形66處,64層CT確診44處,檢出率66.7%；心室段畸形179處,CT確診178處,檢出率99.4%；房室連接段畸形18處,64層CT確診18處,檢出率100%；大動(dòng)脈段畸形101處,64層CT確診94處,檢出率93.1%；心室大動(dòng)脈連接段畸形148處,64層CT確診133處,檢出率89.9%；心臟位置異常13處,64層CT確診13處,檢出率100%。(2)64層螺旋CT與彩色超聲心動(dòng)圖在心房段、心室段、房室連接段、心室大動(dòng)脈連接段、心臟位置異常方面畸形的診斷檢出率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義；在大動(dòng)脈段畸形方面與超聲心動(dòng)圖比較有統(tǒng)計(jì)學(xué)意義,對(duì)大動(dòng)脈段畸形的檢出率明顯優(yōu)于超聲。(3)64層螺旋CT對(duì)房、室間隔缺損大小等計(jì)量指標(biāo)的測(cè)量值與手術(shù)結(jié)果、超聲診斷結(jié)果分別比較,差異無(wú)統(tǒng)計(jì)學(xué)意義。 結(jié)論(1)64層螺旋CT掃描速度快,時(shí)間、空間、密度分辨率高,達(dá)到各向同性,憑借各種后處理技術(shù)重組的圖像能全面、準(zhǔn)確、直觀顯示全心畸形類先天性心臟病各種心血管結(jié)構(gòu)異常,因此是先天性心臟病的一項(xiàng)重要無(wú)創(chuàng)檢查技術(shù)。(2)64層螺旋CT血管造影對(duì)全心類心血管畸形心房、心室、房室連接、心室大動(dòng)脈連接段以及心臟位置異常的檢出率與彩色超聲心動(dòng)圖比較無(wú)明顯優(yōu)勢(shì),而對(duì)大動(dòng)脈段的畸形檢出率優(yōu)于超聲心動(dòng)圖；無(wú)法顯示瓣膜功能改變；64層螺旋CT與超聲心動(dòng)圖互相補(bǔ)充、聯(lián)合診斷可提高對(duì)先心病心血管結(jié)構(gòu)異常的診斷準(zhǔn)確率,并了解血流動(dòng)力學(xué)改變。(3)64層螺旋CT心臟檢查藉由多種后處理技術(shù),配合使用順序分段分析可全面、正確了解先心病各種心血管異常的形態(tài)學(xué)改變,對(duì)臨床治療方案制定提供豐富、直觀的影像學(xué)信息。
[Abstract]:Objective to analyze the 64 slice spiral CT images of congenital heart disease of whole heart by sequential segmental analysis, and to explore the clinical value of sequential segmental analysis in diagnosing congenital heart disease by MSCT.
Methods 98 cases with 64 slice spiral CT and echocardiography and confirmed by surgery for heart malformation of congenital heart disease patients. There were 63 male and 35 female patients, aged from 1 months to 47 years of age, the average age of 10.07 + 9.78 years; all cases were confirmed by GE Lightspeed VCT 64 slice spiral CT plain and bolus enhancement scan, enhanced using bolus tracking technology, obtaining image into ADW4.4 postprocessing workstation, using multi planar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR) reconstruction method, observation of cardiac vascular position, cardiovascular malformation signs form change and merge, piecewise analysis analyzing diagnosis method in order to list the morphological deformity of the corresponding segments and then aggregated statistics, and finally the corresponding echocardiography and surgical results were compared.
Results (1) morphology of 64 slice spiral CT with heart malformations of congenital heart disease deformity showed that atrial section 66 deformities, 64 CT were 44, the detection rate of 66.7%; ventricular segment 179 deformities, CT was 178, the detection rate of 99.4%; 18 deformities with atrioventricular segment, 64 layer CT with 18, the detection rate of 100%; the large artery malformation 101, 64 layer CT diagnosed 94, the detection rate of 93.1%; ventricular arterial connection section 148 deformities, 64 CT were 133, the detection rate of 89.9%; cardoanastrophe 13, 64 layer CT were 13, the detection rate of 100%. (2) 64 slice spiral CT and color Doppler echocardiography in atrial, ventricular, atrioventricular junction, ventricular arterial connection, heart abnormalities to diagnose abnormalities, no significant difference; in large artery segment deformity and echocardiography was statistically significant, the artery malformation the detection rate was significantly It is better than ultrasound. (3) there is no significant difference between the 64 slice spiral CT in measuring the size of atrial septal defect and the results of operation and ultrasonic diagnosis.
緇撹(1)64灞傝灪鏃婥T鎵弿閫熷害蹇，

本文編號(hào)：1509754