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目的评价电子束CT(EBCT)对主动脉-肺动脉间隔缺损(APSD)及其合并畸形的诊断价值。方法7例APSD患者,年龄1-13岁。均行X线平片、超声心动图及EBCT检查。心电门控EBCT血管造影采用270 mg L／ml非离子型对比剂碘海醇,层厚1．5～3．0 mm。其中3例行心血管造影检查,2例有手术对照。将同一患者的各项影像学检查结果及手术所见进行比较并分析。结果7例主-肺动脉间隔缺损EBCT全部诊断,2例经手术证实;3例经心血管造影检查证实;超声心动图仅检出2例。同时,EBCT检查示4例合并右肺动脉起源异常、主动脉弓离断;5例合并动脉导管未闭,均经手术和(或)造影证实;超声心动图检查漏诊右肺动脉起源异常2例,漏诊主动脉弓离断2例;心血管造影漏诊动脉导管未闭l例。结论X线平片、超声心动图、心血管造影及EBCT综合影像诊断是必要的,作为无创性检查方法,EBCT在主动脉-肺动脉间隔缺损及其合并畸形诊断有重要价值。
Objective To evaluate the diagnostic value of electron beam computed tomography (EBCT) for aortic-pulmonary septal defect (APSD) and its associated deformity. Methods Seven APSD patients aged 1-13 years old. All X-ray films, echocardiography and EBCT examination. ECG-gated EBCT angiography with 270 mg L / ml non-ionic contrast agent iohexol, layer thickness 1.5 ~ 3.0 mm. Three of them underwent cardiovascular angiography and two had surgical control. The same patient’s imaging findings and surgical findings were compared and analyzed. Results Seven cases of EBCT were all diagnosed, two cases were confirmed by operation, three cases were confirmed by cardiovascular angiography, and only two cases were detected by echocardiography. At the same time, EBCT examination revealed 4 cases with abnormalities of right pulmonary artery origin, aortic arch disconnection, 5 cases with patent ductus arteriosus confirmed by operation and / or angiography, echocardiography missed diagnosis of right pulmonary artery origin in 2 cases, missed aortic arch Off in 2 cases; missed angiography of patent ductus arteriosus in 1 case. Conclusion X-ray, echocardiography, cardiovascular angiography and EBCT comprehensive imaging diagnosis are necessary. As a noninvasive method, EBCT is of great value in the diagnosis of aortic-pulmonary septal defect and its combined deformity.