摘要目的 探讨多层螺旋CT(MSCT)重组技术对先天性血管环伴气管狭窄的诊断价值.方法 收集温州医学院附属第二医院2004年10月至2010年4月经手术证实的先天性血管环伴气道狭窄患儿9例,均行心脏大血管薄层CT增强扫描,所得数据传至工作站进行多平面重组(MPR)、容积再现技术(VRT)及VR透明化重组,以手术结果为标准,与超声心动图(UCG)对比分析其影像学特点.结果 9例中,肺动脉吊带4例,右位主动脉弓伴左迷走锁骨下动脉3例,双主动脉弓1例,无名动脉压迫综合征1例,其中5例伴有其他心内外畸形(法洛四联症2例,右室双出口伴动脉导管未闭及室间隔缺损1例,室间隔缺损1例,双上腔静脉1例),1例法洛四联症主动脉周围见多发迂曲侧支动脉,上述畸形VRT及MPR均多角度直观显示;VR透明化技术可立体显示气管及支气管受压情况,其中主气管受压6例,主气管及左主支气管受压2例,主气管及右主支气管受压1例;UCG均检出上述心内畸形,1例肺动脉吊带误诊为动脉导管未闭,余8例血管环、气管及支气管狭窄改变均漏诊.结论 MSCT重组技术是一种无创、快速检查方法,可多方位清晰显示先天性血管环及气管受压狭窄程度,有利于临床减少误诊并及时治疗.

abstractsObjective To evaluate the diagnostic value of multi-slice CT (MSCT) reconstructions for congenital vascular rings together with tracheal stenosis. Methods 9 cases of children with congenital vascular ring and tracheal stenosis confirmed by surgery were collected in the study, all cases had undergone thin slice CT contrast enhancement, the MSCT data were transmitted to the workstation for multiplanar reconstruction( MPR), volume rendering technique(VRT) and VR transparency resconstruction. With the surgical results as the gold standard, the imaging characteristics of echocardiography (UCG) and MSCT were comparatively analyzed. Results In 9 cases, there were 4 cases of pulmonary artery sling, 3 cases of right aortic arch combination with left aberrant subclavian artery, 1 case of double aortic arch, Ⅰ case of innominate artery compression syndrome. In this group, 5 cases were accompanied with other cardiac malformations (tetralogy of Fallot in 2 cases, double outlet right ventricle with patent ductus arteriosus and ventricular septal defect in 1 case, ventricular septal defect in 1 case, double superior vena cava in 1 case),1 case of tetralogy of Fallot demonstrated many tortuous collateral arteries around aorta. All malformations were well displayed by VRT, MPR. VR transparency resconstruction can stereoscopically display trachea and bronchial compression condition, the main trachea was compressed in 6 cases, the main trachea and left main bronchus was compressed in 2 cases, the main trachea and left main bronchus was compressed in 1 cases,UCG detected all intracardiac malformations, 1 case of pulmonary artery sling was misdiagnosed as patent ductus arteriosus, 8 cases of vascular rings, tracheal and bronchial stenosis were missed. Conclusion MSCT reconstruction technology is a noninvasive, rapid diagnostic method, it can clearly show the congenital vascular rings abnormalities and the degree of tracheal stenosis, it has important significance for clinic treatment.