摘要目的 探讨双源CT(DSCT)前瞻性心电门控技术在小儿主动脉缩窄诊断中的价值.方法 对16例临床怀疑为主动脉缩窄的患儿行DSCT前瞻性心电门控心胸联合血管成像及心脏彩色多普勒血流显像(CDFI)检查.以手术或DSA结果为标准,采用x2检验比较DSCT和CDFI的诊断准确率.结果 DSCT诊断主动脉缩窄16例,其中伴房间隔缺损(ASD)4例、室间隔缺损(VSD)9例、大动脉转位1例、主动脉弓发育不良3例、动脉导管未闭( PDA)7例、冠状动脉起源异常1例、支气管动脉扩张l例.CDFI诊断主动脉缩窄15例,主动脉弓离断1例,伴ASD 4例、VSD 9例、二叶型主动脉瓣(BAV)2例、大动脉转位1例、主动脉弓发育不良2例、PDA 7例、支气管动脉扩张1例,未发现冠状动脉起源异常.与手术或DSA结果对照:DSCT和CDFI诊断准确率分别为97.2％(140/144)、97.9％ (141/144),两者差异无统计学意义(x2=0.00,P＞0.05),DSCT和CDFI诊断敏感度均为93.2％ (41/44),特异度分别为99.0％ (99/100)和100.0％ (100/100).DSCT前门控平均有效辐射剂量为0.42 mSv.结论 DSCT前瞻性心电门控技术是诊断小儿主动脉缩窄的首选检查方法.

abstractsObjective To investigate the value of prospective ECG-gated dual-source CT (DSCT)in the diagnosis of coarctation of aorta ( CoA ).Methods Sixteen patients clinically suspected of CoA underwent prospective ECG-gated DSCT angiography and color Doppler flow imaging (CDFI). The diagnostic accuracy of DSCT and CDFI were compared according to the results of operation or DSA.The nonparametric chi-square test was used for the statistics.Results Sixteen patients were diagnosed as CoA by DSCT,4 were complicated with artial septal defect (ASD),9 with ventricular septal defect (VSD),1 with transposition of the great arteries,3 with dysplasia of aortic arch,7 with patent ductus arteriosus (PDA),1 with abnormal origin of the coronary artery, 1 with bronchus artery dilation. Fifteen patients were diagnosed as CoA by CDFI,1 was diagnosed as interruption of aortic arch. Four were complicated with ASD,9 with VSD,2 with bicuspid aortic valve (BAV),1 with transposition of the great arteries,2 with dysplasia of aortic arch,7 with PDA,1 with bronchus artery dilation.Abnormal origin of the coronary artery was not found.The diagnostic accuracy of DSCT and CDFI were 97.2％ ( 140/144)and 97.9％ (141/144)respectively,there was no significant difference (x2 =0.00,P ＞ 0.05 ).The sensitivity of DSCT and CDFI were both 93.2％ ( 41/44 ),the specificity were 99.0％ (99/100) and 100.0％ (100/100).The mean effective radiation dose was 0.42 mSv. Conclusion Prospective ECG-gated DSCT is a good imaging technique for the diagnosis of aortic coarctation in children.