双源计算机断层扫描评估青紫型先天性心脏病患儿肺动脉：与经胸超声心动图的比较。

Dual-source computed tomography for evaluating pulmonary artery in pediatric patients with cyanotic congenital heart disease: Comparison with transthoracic echocardiography.

作者信息

Shi Ke, Yang Zhi-Gang, Xu Hua-Yan, Zhao Si-Xiu, Liu Xi, Guo Ying-Kun

机构信息

Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.

出版信息

Eur J Radiol. 2016 Jan;85(1):187-192. doi: 10.1016/j.ejrad.2015.11.002. Epub 2015 Nov 4.

DOI:10.1016/j.ejrad.2015.11.002

PMID:26724664

Abstract

PURPOSE

To evaluate the quantitative accuracy of dual-source computed tomography (DSCT) on measurements of pulmonary artery in pediatric patients with cyanotic congenital heart diseases (CCHDs) when compared with transthoracic echocardiography (TTE).

METHODS

Thirty-five patients (mean age: 27.88 ± 28.27 months) with CCHDs underwent DSCT and TTE for evaluating the diameter of the main pulmonary artery (MPA), right pulmonary artery (RPA), and left pulmonary artery (LPA). Surgical measurements were obtained and served as the reference standard. The agreement was tested by linear regression analysis, Pearson's correlation coefficient, and Bland-Altman analysis. The intra- and extracardiac malformations were also observed.

RESULTS

There was a markedly positive correlation between DSCT and surgical measurements of the MPA, RPA, and LPA (r=0.95-0.97; all p<0.001), although the overestimation of the measurements of MPA, RPA, and LPA (bias 0.15 ± 0.95, 0.31 ± 0.63 and 0.35 ± 0.68 mm, respectively) was observed. However, there was a moderate correlation between TTE and surgical measurements of MPA, RPA, and LPA (r=0.61-0.84; all p<0.001), and the underestimation of the measurements of MPA, RPA, and LPA (bias-1.20 ± 1.69, -1.80 ± 1.77, and -1.50 ± 2.30 mm, respectively) was observed. In addition, DSCT was more efficient in finding associated malformations than TTE (40/40 vs. 33/40).

CONCLUSIONS

As a reliable, noninvasive and radiation-save imaging modality, DSCT can provide more accurate pulmonary artery measurements than TTE in cardiac surgical procedures.

摘要

目的

与经胸超声心动图（TTE）相比，评估双源计算机断层扫描（DSCT）对青紫型先天性心脏病（CCHD）患儿肺动脉测量的定量准确性。

方法

35例（平均年龄：27.88±28.27个月）CCHD患儿接受DSCT和TTE检查，以评估主肺动脉（MPA）、右肺动脉（RPA）和左肺动脉（LPA）的直径。获取手术测量值并将其作为参考标准。通过线性回归分析、Pearson相关系数和Bland-Altman分析来检验一致性。同时观察心内和心外畸形情况。

结果

DSCT与MPA、RPA和LPA的手术测量值之间存在显著正相关（r=0.95 - 0.97；均p<0.001），尽管观察到MPA、RPA和LPA测量值存在高估（偏差分别为0.15±0.95、0.31±0.63和0.35±0.68 mm）。然而，TTE与MPA、RPA和LPA的手术测量值之间存在中等程度的相关性（r=0.61 - 0.84；均p<0.001），并且观察到MPA、RPA和LPA测量值存在低估（偏差分别为-1.20±1.69、-1.80±1.77和-1.50±2.30 mm）。此外，DSCT在发现相关畸形方面比TTE更有效（40/40对33/40）。