经胸超声心动图与双源螺旋CT在儿童先天性心脏病术前诊断中的应用价值

摘要/Abstract

摘要： 目的探讨经胸超声心动图与双源螺旋CT在儿童先天性心脏病术前诊断中的应用价值。方法选择2019年2月—2022年12月在兰州市第一人民医院住院并进行诊治的66例疑似先天性心脏病小儿作为研究对象,术前对这些患儿均进行经胸超声心动图检查与双源螺旋CT检查,以手术结果作为金标准,比较超声组与CT组的图像质量主观评分,儿童先天性心脏病术前双源螺旋CT检查的辐射剂量与噪声、信噪比,手术诊断情况及经胸超声心动图与双源螺旋CT在儿童先天性心脏病术前的诊断价值。结果在超声检查与CT检查中心内结构、心脏大血管、冠状动脉近段的图像质量主观评分均>4分,差异无统计学意义（P>0.05）。在进行CT检查时,剂量长度乘积为（13.20±2.18）mGy,有效剂量为（0.27±0.03）mSv,心脏大血管的对比噪声比（CNR）值（8.22±0.47）。手术诊断为先天性心脏病38例,其中,房间隔缺损15例,单心房9例,室间隔缺损6例,瓣膜病变3例,三房心2例,单心室2例,心内膜垫缺损1例;在超声检查中,超声诊断为先天性心脏病36例,房间隔缺损2例被漏诊;在双源螺旋CT检查中,CT诊断为先天性心脏病38例,无漏诊误诊情况。经胸超声心动图与双源螺旋CT在术前诊断中的敏感性为94.74%和100.00%,特异性为100.00%和100.00%,ROC曲线显示经胸超声心动图与双源螺旋CT预测的曲线下面积分别为0.963、1.000。结论经胸超声心动图与双源螺旋CT在儿童先天性心脏病术前诊断中的应用都有很高的敏感性与特异性,都能为先天性心脏病的临床诊治提供一定的依据。

关键词: 经胸超声心动图, 双源螺旋CT, 先天性心脏病, 儿童, 敏感性, 特异性, 辐射剂量

Abstract: Objective To investigate the application value of transthoracic echocardiography and double-source spiral CT in preoperative diagnosis of congenital heart disease in children. Methods A total of 66 cases of suspected congenital heart disease who were hospitalized and treated in Lanzhou First People's Hospital from February 2019 to December 2022 were collected as the study subjects. Before these patients, transthoracic echocardiography and double-source spiral CT were performed, and the surgical. Results were taken as the gold standard, comparing the subjective scores of image quality between ultrasound and CT groups, radiation dose and noise and signal-to-noise ratio of preoperative dual source spiral CT, surgical diagnosis, and the diagnostic value of transthoracic echocardiography and dual source spiral CT in children with congenital heart disease. Results The subjective score of the image quality of the structure, the near coronary artery between the ultrasound and CT were>4 points, and the contrast showed no significant difference (P>0.05). At the CT test, the dose length product was (13.20±2.18) mGy, the effective dose was (0.27±0.03) mSv, the cardiac macro-vessel CNR value was (8.22±0.47). The surgical diagnosis was 38 cases of congenital heart disease, included 15 atrial septal defects, 9 single atrium, 6 ventricular septal defects, 3 valvular lesions, 2 triplicate hearts, 2 single ventricles and 1 endocardial pad defect. In ultrasound examination, 36 cases of congenital heart disease and 2 cases of atrial septal defect were missed, 38 cases of CT with no missed misdiagnosis. Transthoracic echocardiography with bisource spiral CT had 94.74% and 100.00% sensitivity and 100.00% and 100.00% for preoperative diagnosis, and the ROC curve showed that the area under the curve predicted by transthoracic echocardiography was 0.963 and 1.000, respectively. Conclusion The application of transthoracic echocardiography and double-source spiral CT in preoperative diagnosis of congenital heart disease in children has high sensitivity and specificity, and both can provide a certain basis for clinical diagnosis and treatment of congenital heart disease.

Key words: transthoracic echocardiography, dual-source spiral CT, congenital heart disease, children, sensitivity, specificity, radiation dosage

中图分类号:

R445.1

谢记文, 龙晓莉, 谢静. 经胸超声心动图与双源螺旋CT在儿童先天性心脏病术前诊断中的应用价值[J]. 中华养生保健, 2023, 41(19): 50-53.

XIE Ji-wen, LONG Xiao-li, XIE Jing. Application Value of Transthoracic Echocardiography and Dual-Source Spiral CT in the Preoperative Diagnosis of Congenital Heart Disease in Children[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(19): 50-53.

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