| ObjectiveTo investigate the clinical value of DSCT preoperation in the assessment of the cardiovascular malformation in complex congenital heart disease with diminished pulmonary blood flow and compared with echocardiography.Materials and methods130 patients schedules for operation because of suspected or definited complex congenital heart disease with diminished pulmonary blood flow were examined by DSCT, of which 72 men and 58 women, age 4m-35y (average 8.3±6.7y), the HR were 57bpm-134bpm (average 95.0±20.6bpm). The symptom and physical sign as follows:cyanoderma of lips and skin, acropachy or clubbing of toes, cardic systolic or diastolic murmur could be heard at cardiac auscultation area.A combination of restruction with images of end-systole, including maximum intensify projection, multi-planar reconstruction, volume rendering, and so on. Seek the cardiovascular malformation according to the Van Praagh Segment analytical method. Analysis the DSCT and the echocardiography' diagnosis with that of the operation. ResultsThere were 493 places of malformation for all the 130 patients, of which 205 internus malformation and 288 ectal malformation.①Of the 205 places of internus malformation,189 places were directly diagnosed by DSCT and the diagnostic accuracy was 92.2%, and the echocardiography'diagnostic accuracy was 95.61%(196/205), There were no significant difference between DSCT and echocardiography(x2=2.087, P>0.05). The diagnostic accuracy of the two conjunction was superior to DSCT(x2=9.437, P<0.05).②Of the 288 places of ectal malformation,276 places were directly diagnosed by DSCT and the diagnostic accuracy was 95.83%, and the echocardiography'diagnostic accuracy was 82.99%(239/288), There had significant difference between DSCT and echocardiography (x2=25.101, P<0.01), whereas no significant difference between DSCT and the two conjunction(x2=2.065, P>0.05).③For all the 493 places of cardiovascular malformation, the diagnostic accuracy of DSCT, echocardiography and the two conjunction were 92.90%,88.24%,97.57%, respectively. There were significant difference between the two conjunction and DSCT or echocardiography for assessment of cardiovascular malformation (P<0.05).ConclusionCompared with echocardiography, DSCT is superior for quantitative assessment of the ectal malformation but reverse for the internus malformation, DSCT combine echocardiography can positively improve the diagnostic accuracy of complex congenital heart disease with diminished pulmonary blood flow.ObjectiveTo investigate the clinical value of DSCT preoperation in the assessment of the pulmonary arteries in complex congenital heart disease with diminished pulmonary blood flow and compared with echocardiography. Materials and methods79 patients schedules for operation because of suspected or definited complex congenital heart disease with diminished pulmonary blood flow were examined by DSCT, of which 43 men and 36 women, age 4m-19y (average 7.35±5.95y), the HR were 57bpm-152bpm (average 115.59±34.72bpm), hight were 57cm-170cm (average 113.59±34.98cm), and wight 6Kg-59Kg (average 29.63±1.69Kg). The symptom and physical sign as follows:cyanoderma of lips and skin, acropachy or clubbing of toes, grade III-IVsystolic murmur could be heard at cardiac auscultation area.A combination of restruction with images of end-systole, including maximum intensify projection, multi-planar reconstruction, volume rendering, and so on.8 aspects reflceting pulmonary artery'developmental capacity were concerned, including the pulmonary artery trunk, left pulmonary artery, right pulmonary artery, ascending aorta, descending aorta at the diaphragma level, McGoon index, aorta-pulmonary ratio and Nakata index, whose results were subjected to statistical analysis using Pearson's correlation and t-test analysis compared with that of echocardiography.ResultsThe pulmonary arteries could be clearly observed from original images and reconstruction images. There were no significant difference between DSCT and echocardiography for the noninvasive assessment of pulmonary artery anatomy (P >0.05), but significant difference for the diagnosis of aortopulmonary collateral arteries (P< 0.05). The measurement parameters (including the McGoon index, aorta-pulmonary ratio and Nakata index) correlate well with each other by DSCT and echocardiography (Pearson's coefficient of correlation: r=0.746/0.832/0.785).ConclusionCompared with echocardiography, DSCT is superior for quantitative assessment of pulmonary artery'developmental capacity, therefore it would be helpful to evaluate the pulmonary development condition preoperation of complex congenital heart disease with diminished pulmonary blood flow. ObjectiveTo investigate the diagnosis of DSCT preoperation about the left ventricular function for complex congenital heart disease with diminished pulmonary blood flow in comparison to 2D-echocardiography.Materials and methods50 patients schedules for operation because of suspected or definited complex congenital heart disease with diminished pulmonary blood flow were examined by DSCT, of which 24 men and 26 women, age 4m-19y (average 6.79±4.13y), the HR were 57bpm-152bpm (average 112.55±23.34bpm), hight were 57cm-167cm (average 113.65±26.38cm), and wight 6Kg-54Kg(average 25.54±2.09Kg). The symptom and physical sign as follows:cyanoderma of lips and skin, acropachy or clubbing of toes, gradeⅢ-Ⅳsystolic murmur could be heard at cardiac auscultation area.Restruct the whole phase of the cardiac cycle, including the maximum intensify projection, multi-planar reconstruction, volume rendering. The DSCT images were reconstructed at 5 percent of the R-R interval and were evaluated at the best end-diastole and end-systole. The images were quantitatively assessed, end-systolic volumes (ESV), end-diastolic volumes(EDV), stroke volume (SV), ejection fraction (EF), and the fraction shortening(FS) of left ventricular function were obtained and statistically analyzed with that of 2D-echocardiography using Pearson's correlation and t-test analysis.ResultsDSCT revealed a strong correlation with 2D-echocardiography regarding the quantification of ESV (r=0.916), EDV(r=0.957), SV(r=0.953), whereas the agreement for EF and FS was only moderate:EF(r=0.825), FS(r=0.718). Statistical analysis revealed little systematic underestimation of EF and FS, and little overestimation of ESV, EDV and SV determined by DSCT compared with 2D-echocardiography.ConclusionDSCT allows for accurate assessment of global functional parameters disregarding heart rate, it could be a reliable preoperation evaluation method for complex congenital heart disease with diminished pulmonary blood flow. |
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