Huang Fang, Chen Qiang, Huang Wen-Han, Wu Hong, Li Wei-Cheng, Lai Qing-Quan
Department of Radiology, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian, China (mainland).
Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, China (mainland).
Med Sci Monit. 2017 May 16;23:2308-2314. doi: 10.12659/msm.901928.
BACKGROUND The purpose of this study was to evaluate the utility of multi-detector computed tomography (MDCT) angiography and transthoracic echocardiography (TTE) in the diagnosis of congenital coarctation of the aorta (CoA) and accompanying malformations in infants. MATERIAL AND METHODS From January 2012 and December 2015, we enrolled 68 infants with clinically suspected CoA who underwent MDCT angiography and TTE in our hospital. Surgical correction was conducted to confirm the diagnostic accuracy of both examinations in all patients. RESULTS In this study, the diagnosis of CoA was confirmed infants by surgical results in 55 of 68 infants. The diagnostic accuracy, sensitivity, and specificity of MDCT angiography were 95.6%, 96.4%, and 92.3%, respectively. The diagnostic accuracy, sensitivity, and specificity of TTE were 88.2%, 90.9%, and 76.9%, respectively. There was no significant difference in diagnostic accuracy, sensitivity, and specificity between MDCT angiography and TTE (χ²=2.473, p>0.05, χ²=1.373, p>0.05 and χ²=1.182, p>0.05, respectively). In the diagnosis of concomitant cardiac abnormalities with CoA, the 2 methods also play different roles. CONCLUSIONS MDCT angiography and TTE play different roles in the diagnosis of CoA and accompany malformations. MDCT angiography in the diagnosis of the extra-cardiac vascular malformations is better than TTE, and TTE is superior to MDCT angiography in diagnosing intracardiac malformation. Combined MDCT angiography and TTE is a relatively valuable, reliable, and noninvasive method in the diagnosis of CoA and accompany malformations in infants.
背景 本研究的目的是评估多排螺旋计算机断层扫描（MDCT）血管造影和经胸超声心动图（TTE）在诊断婴儿先天性主动脉缩窄（CoA）及伴随畸形中的应用价值。
材料与方法 2012年1月至2015年12月，我们纳入了68例临床疑似CoA的婴儿，这些婴儿在我院接受了MDCT血管造影和TTE检查。对所有患者均进行手术矫正以确认两种检查的诊断准确性。
结果 在本研究中，68例婴儿中有55例经手术结果证实患有CoA。MDCT血管造影的诊断准确性、敏感性和特异性分别为95.6%、96.4%和92.3%。TTE的诊断准确性、敏感性和特异性分别为88.2%、90.9%和76.9%。MDCT血管造影和TTE在诊断准确性、敏感性和特异性方面无显著差异（χ²分别为2.473、p>0.05，χ²为1.373、p>0.05，χ²为1.182、p>0.05）。在诊断CoA合并心脏异常方面，这两种方法也发挥着不同的作用。
结论 MDCT血管造影和TTE在CoA及伴随畸形的诊断中发挥着不同的作用。MDCT血管造影在诊断心脏外血管畸形方面优于TTE，而TTE在诊断心脏内畸形方面优于MDCT血管造影。联合使用MDCT血管造影和TTE是诊断婴儿CoA及伴随畸形的一种相对有价值、可靠且无创的方法。
