嬰幼兒圓錐動脈干畸形型先天性心臟病合并冠狀動脈異位起源的MSCT診斷
發(fā)布時間：2019-04-23 07:37
【摘要】：目的:研究圓錐動脈干畸形型先天性心臟病合并冠狀動脈異位起源的類型、發(fā)生率、構(gòu)成比,探討術(shù)前MSCT心臟成像診斷對術(shù)前計劃制定的重要性。方法:回顧性分析276例經(jīng)手術(shù)證實的圓錐動脈干畸形型先天性心臟病,所有患兒均在本院行MSCT心臟成像,并記錄先天性心臟病類型、冠狀動脈異位起源的類型及數(shù)量。對不同類型先天性心臟病的冠狀動脈異位起源的發(fā)生率采用行×列Person卡方檢驗進(jìn)行比較,對不同先天性心臟病的冠狀動脈異位起源構(gòu)成比采用Fisher確切概率法進(jìn)行比較。與手術(shù)結(jié)果對照,探討術(shù)前MSCT心臟成像診斷對術(shù)前計劃制定的重要性。結(jié)果:圓錐動脈干畸形型先天性心臟病共276例,合并冠狀動脈異位起源者47例,平均發(fā)病率為17%,其中肺動脈閉鎖PA 11例,大動脈轉(zhuǎn)位TGA 15例,法洛氏四聯(lián)癥TOF 4例,永存動脈干PTA 6例,右室雙出口DORV 11例。在本組圓錐動脈干畸形型先天性心臟病伴發(fā)冠狀動脈異位起源中,單冠狀動脈SCA最多,占48.94%,其次為對側(cè)冠狀動脈或無冠竇起源OO,占29.79%,冠狀動脈多發(fā)起源MO占14.89%,冠狀動脈高位起源HO為4.26%,冠狀動脈肺動脈起源PO最少,占2.13%。Fisher確切概率法比較,卡方值為15.452,P值為0.472,說明不同類型先天性心臟病的冠狀動脈異位起源構(gòu)成比差異無統(tǒng)計學(xué)意義,可以認(rèn)為不同類型先天性心臟病的冠狀動脈異位起源構(gòu)成比不全相同,與圓錐動脈干畸形的嚴(yán)重程度相關(guān)。本研究冠狀動脈異位起源發(fā)生率由高到低依次為PTA(35.3%)TGA(27.3%)DORV(25%)PA(16.9%)TOF(4.2%)。但是TGA的構(gòu)成比高達(dá)32%。結(jié)論:不同類型圓錐動脈干畸形型先天性心臟病合并冠狀動脈異位起源的發(fā)生率及構(gòu)成比不同,與圓錐動脈干畸形的嚴(yán)重程度相關(guān);我們應(yīng)該更多地關(guān)注大動脈轉(zhuǎn)位伴發(fā)冠狀動脈異位起源的患兒。
[Abstract]:Aim: to study the types, incidence and composition ratio of congenital heart disease complicated with coronary artery ectopic origin in conic artery trunk malformation, and to explore the importance of preoperative MSCT cardiac imaging diagnosis in preoperative planning. Methods: MSCT cardiography was performed in 276 children with congenital heart disease proved by operation. The types of congenital heart disease, the type and quantity of anomalous origin of coronary artery were recorded. The incidence of heterotopic origin of coronary artery in different types of congenital heart disease was compared by X-ray Person Chi-square test, and the composition ratio of heterotopic origin of coronary artery in different congenital heart disease was compared by Fisher exact probability method. Compared with the results of operation, the importance of preoperative MSCT cardiac imaging in preoperative planning was discussed. Results: there were 276 cases of conic artery trunk malformation congenital heart disease, 47 cases complicated with heterotopic origin of coronary artery, the average incidence was 17%, 11 cases of pulmonary atresia PA, 15 cases of transposition of great artery, 4 cases of TOF of tetralogy of Fallot, 11 cases of pulmonary atresia, 15 cases of transposition of great artery, 4 cases of TOF. There were 6 cases of persistent arterial trunk PTA and 11 cases of right ventricular double outlet DORV. In this group, single coronary artery SCA (48.94%) was the highest, followed by contralateral coronary artery or non-coronary sinus origin OO, (29.79%). The MO of multiple origin of coronary artery was 14.89%, the HO of high origin of coronary artery was 4.26%, the PO of origin of coronary artery and pulmonary artery was the least, the exact probability of 2.13%.Fisher was 15.452, P value was 0.472, The results showed that there was no significant difference in the composition ratio of the heterotopic origin of coronary artery between different types of congenital heart disease, and that the composition ratio of the heterotopic origin of coronary artery in different types of congenital heart disease was not all the same. It is related to the severity of conus arteriosus malformations. The incidence of coronary heterotopic origin was PTA (35.3%) TGA (27.3%) DORV (25%) PA (16.9%) TOF (4.2%). But TGA has a composition ratio of 32%. Conclusion: the incidence and composition of different types of congenital heart disease complicated with coronary artery heterotopic origin are different, which is related to the severity of Cone artery trunk malformation. We should pay more attention to children with transposition of the great artery with heterotopic origin of coronary artery.
【作者單位】： 廣州白云區(qū)人民醫(yī)院放射科 廣東省婦幼保健院放射科 廣州醫(yī)科大學(xué)附屬第一醫(yī)院放射科
【分類號】：R725.4;R816.92
[Abstract]:Aim: to study the types, incidence and composition ratio of congenital heart disease complicated with coronary artery ectopic origin in conic artery trunk malformation, and to explore the importance of preoperative MSCT cardiac imaging diagnosis in preoperative planning. Methods: MSCT cardiography was performed in 276 children with congenital heart disease proved by operation. The types of congenital heart disease, the type and quantity of anomalous origin of coronary artery were recorded. The incidence of heterotopic origin of coronary artery in different types of congenital heart disease was compared by X-ray Person Chi-square test, and the composition ratio of heterotopic origin of coronary artery in different congenital heart disease was compared by Fisher exact probability method. Compared with the results of operation, the importance of preoperative MSCT cardiac imaging in preoperative planning was discussed. Results: there were 276 cases of conic artery trunk malformation congenital heart disease, 47 cases complicated with heterotopic origin of coronary artery, the average incidence was 17%, 11 cases of pulmonary atresia PA, 15 cases of transposition of great artery, 4 cases of TOF of tetralogy of Fallot, 11 cases of pulmonary atresia, 15 cases of transposition of great artery, 4 cases of TOF. There were 6 cases of persistent arterial trunk PTA and 11 cases of right ventricular double outlet DORV. In this group, single coronary artery SCA (48.94%) was the highest, followed by contralateral coronary artery or non-coronary sinus origin OO, (29.79%). The MO of multiple origin of coronary artery was 14.89%, the HO of high origin of coronary artery was 4.26%, the PO of origin of coronary artery and pulmonary artery was the least, the exact probability of 2.13%.Fisher was 15.452, P value was 0.472, The results showed that there was no significant difference in the composition ratio of the heterotopic origin of coronary artery between different types of congenital heart disease, and that the composition ratio of the heterotopic origin of coronary artery in different types of congenital heart disease was not all the same. It is related to the severity of conus arteriosus malformations. The incidence of coronary heterotopic origin was PTA (35.3%) TGA (27.3%) DORV (25%) PA (16.9%) TOF (4.2%). But TGA has a composition ratio of 32%. Conclusion: the incidence and composition of different types of congenital heart disease complicated with coronary artery heterotopic origin are different, which is related to the severity of Cone artery trunk malformation. We should pay more attention to children with transposition of the great artery with heterotopic origin of coronary artery.
【作者單位】： 廣州白云區(qū)人民醫(yī)院放射科 廣東省婦幼保健院放射科 廣州醫(yī)科大學(xué)附屬第一醫(yī)院放射科
【分類號】：R725.4;R816.92
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