多排螺旋 CT 评估肺血增多相关先天性心脏病患者的肺气肿改变。

Pulmonary emphysematous changes in patients with congenital heart disease associated with increased pulmonary blood flow: evaluation using multidetector-row computed tomography.

机构信息

Department of Pediatrics, University of Tokushima, Kuramoto-cho-3, Tokushima 770-8503, Japan.

出版信息

Heart Lung Circ. 2011 Sep;20(9):587-92. doi: 10.1016/j.hlc.2011.04.038. Epub 2011 May 28.

DOI:10.1016/j.hlc.2011.04.038

PMID:21621459

Abstract

BACKGROUND

The present study aimed to evaluate the prevalence and the location of segmental emphysematous change in congenital heart disease (CHD) patients with increased pulmonary blood flow using multidetector-row computed tomography (MDCT).

METHODS

A total of 129 consecutive patients (mean age, 5.8±5.4 years; range, 1 month to 24 years) underwent MDCT angiography of the thorax. The frequency of emphysematous change was evaluated in patients with ventricular septal defect (VSD, n=61), atrial septal defect (ASD, n=27), patent ductus arteriosus (PDA, n=36) and complete atriventriclar septal defect (CAVSD, n=5). In 59 patients who underwent cardiac catheterisation, the relationships between the emphysematous change and both pulmonary to systemic blood flow ratio (Qp/Qs) and mean pulmonary arterial pressure (mPAP) were evaluated.

RESULTS

The emphysematous change was detected in 57 patients (44.2%) out of 129 patients. The frequency of segmental emphysematous change in left side was higher than in right side (14.8% vs. 6.5%). Both Qp/Qs and mPAP affected the presence of emphysema.

CONCLUSION

MDCT can provide accurate detection of segmental emphysema in patients with CHD. Emphysematous change is not uncommon pathological lesion in children and adolescents with CHD.

摘要

背景

本研究旨在使用多排螺旋 CT（MDCT）评估肺血流量增加的先天性心脏病（CHD）患者的节段性肺气肿改变的发生率和位置。

方法

共对 129 例连续患者（平均年龄 5.8±5.4 岁；年龄范围 1 个月至 24 岁）进行了胸部 MDCT 血管造影。评估了室间隔缺损（VSD，n=61）、房间隔缺损（ASD，n=27）、动脉导管未闭（PDA，n=36）和完全性房室间隔缺损（CAVSD，n=5）患者肺气肿改变的频率。在 59 例接受心导管检查的患者中，评估了肺气肿改变与肺血流量与体循环血流量比值（Qp/Qs）和平均肺动脉压（mPAP）之间的关系。