Department of Radiology, Fukuoka Children's Hospital, Fukuoka, Japan.
Department of Radiology, Hara Sanshin Hospital, Fukuoka, Japan.
Jpn J Radiol. 2019 Apr;37(4):308-314. doi: 10.1007/s11604-018-00807-x. Epub 2019 Jan 2.
The purpose of this study was to investigate whether the origins and courses of the coronary arteries could be better assessed using ECG-gated dual-source computed tomography (CT) than with echocardiography in neonates with transposition of the great arteries (TGA).
A total of 17 neonates within 14 days old who underwent both echocardiography and retrospective ECG-gated coronary CT angiography were retrospectively reviewed. The patients were sedated and intubated during CT examinations, and CT images were obtained with a breath-hold. CT images were reconstructed by multiple cardiac phases, and the coronary artery assessment was performed in the most static phase. Coronary anomalies were classified by Shaher's classification and validated by surgical findings.
CT correctly classified 16 of 17 cases (Shaher type 1: 7, type 2: 4, type 9: 3, type 3: 1, type 4: 2), whereas echocardiography classified only 8 of 17 cases correctly. Dual-source CT had a significantly higher diagnostic ability than echocardiography (p = 0.0078).
Dual-source coronary CT angiography has a higher diagnostic ability than echocardiography in the assessment of the origins and courses of the coronary arteries in neonates with TGA.
本研究旨在探讨心电图门控双源 CT（ECG-gated dual-source CT，DSCT）在评估大动脉转位（transposition of the great arteries，TGA）新生儿冠状动脉起源和走行方面是否优于超声心动图。
回顾性分析了 17 例在 14 天内接受超声心动图和回顾性 ECG 门控冠状动脉 CT 血管造影（coronary CT angiography，CCTA）检查的新生儿。在 CT 检查期间，患儿需镇静并气管插管，进行屏气扫描。重建时使用多个心动周期图像，在最静止的相位进行冠状动脉评估。冠状动脉异常采用 Shaher 分类法进行分类，并通过手术结果进行验证。
CT 正确分类了 17 例中的 16 例（Shaher 1 型：7 例，2 型：4 例，9 型：3 例，3 型：1 例，4 型：2 例），而超声心动图仅正确分类了 8 例。DSCT 的诊断能力明显优于超声心动图（p = 0.0078）。
在评估 TGA 新生儿冠状动脉起源和走行方面，双源冠状动脉 CT 血管造影术比超声心动图具有更高的诊断能力。
