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应用双源 CT 评估主动脉缩窄和主动脉弓中断伴发的心内和心外畸形。

Assessment of intracardiac and extracardiac anomalies associated with coarctation of aorta and interrupted aortic arch using dual-source computed tomography.

机构信息

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

Department of Radiology, West China Second University Hospital, Sichuan University, 20# Section 3 South Renmin Road, Chengdu, Sichuan, 610041, China.

出版信息

Sci Rep. 2019 Aug 12;9(1):11656. doi: 10.1038/s41598-019-47136-1.

Abstract

To evaluate the value of dual-source computed tomography (DSCT) compared with transthoracic echocardiography (TTE) in assessing intracardiac and extracardiac anomalies in patients with coarctation of aorta (CoA) and interrupted aortic arch (IAA). Seventy-five patients (63 with CoA and 12 with IAA) who received preoperative DSCT and TTE were retrospectively studied. Intracardiac and extracardiac anomalies were recorded and compared by DSCT and TTE, in reference to surgical or cardiac catheterization findings. A total of 155 associated anomalies were finally found. Collateral circulation (56, 74.70%), patent ductus arteriosus (PDA; 41, 54.67%) were the most common anomalies. PDA, aortopulmonary window, and collateral circulation were more frequently present in patients with IAA than those with CoA (100% vs. 46.03%, 16.67% vs. 0%, and 100% vs. 69.84%, respectively, all p < 0.05). DSCT was superior to TTE in assessing associated extracardiac-vascular anomalies (sensitivity: 100% vs. 39.81%; specificity: 100% vs. 100%; positive predictive value: 100% vs. 100%; negative predictive value: 100% vs. 76.06%). Extracardiac-vascular anomalies, including collateral circulation and PDA, were the most common anomalies in patients with IAA and CoA. Compared with TTE, DSCT is more reliable in providing an overall preoperative evaluation of morphological features and extracardiac anomalies for surgical planning.

摘要

评估双源 CT(DSCT)与经胸超声心动图(TTE)在评估主动脉缩窄(CoA)和主动脉弓中断(IAA)患者心内和心外异常的价值。回顾性研究了 75 例接受术前 DSCT 和 TTE 的患者(63 例 CoA,12 例 IAA)。通过 DSCT 和 TTE 记录并比较心内和心外异常,并与手术或心导管检查结果进行比较。最终发现了 155 种相关异常。侧支循环(56,74.70%)、动脉导管未闭(PDA;41,54.67%)是最常见的异常。IAA 患者中 PDA、主动脉肺动脉窗和侧支循环的发生率高于 CoA 患者(100%比 46.03%、16.67%比 0%和 100%比 69.84%,均 p<0.05)。DSCT 在评估心外血管相关异常方面优于 TTE(敏感性:100%比 39.81%;特异性:100%比 100%;阳性预测值:100%比 100%;阴性预测值:100%比 76.06%)。心外血管异常,包括侧支循环和 PDA,是 IAA 和 CoA 患者最常见的异常。与 TTE 相比,DSCT 在为手术计划提供形态特征和心外异常的全面术前评估方面更可靠。

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