Preoperative evaluation of anomalous pulmonary venous connection using dual-source computed tomography: Comparison with echocardiography
Preoperative evaluation of anomalous pulmonary venous connection using dual-source computed tomography: Comparison with echocardiography
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DOI：
10.1016/j.ejrad.2017.06.015
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发表时间：
2017-09-01
影响因子：
3.3
通讯作者：
Guo, Ying-kun
中科院分区：
文献类型：
--
作者：
Jiang, Li;Xie, Lin-jun;Guo, Ying-kun
目的：目的：评价双源CT（DSCT）与经胸超声心动图（TTE）对肺静脉异位引流（APVC）的诊断价值。分析39例完全性肺静脉异位引流（TAPVC）和84例部分性肺静脉异位引流（PAPVC）的合并畸形。对75例接受手术治疗的患者，评价DSCT和TTE手术结果之间的诊断一致性。结果：房间隔缺损是APVC最常见的畸形（86/123，69.9%），TAPVC的房间隔缺损发生率高于PAPVC（100%vs.56.0%，p < 0.001）。在75例手术患者中，DSCT和TTE对不同引流部位、心上型和心下型的诊断敏感性存在差异。（94.4%与82.2%，p= 0.001），心脏（98.7% vs. 91.1%，p= 0.089），心下型（100% vs. 57.1%，p = 0.096），对于不同的静脉来源，右上级肺静脉（98.4% vs. 87.1%，p = 0.871），右下肺静脉（100% vs. 87.3%，p = 0.006），左上级肺静脉（100% vs. 93.1%，p= 0.246）、左下肺静脉（100% vs. 95.7%，p= 0.500）和非典型肺静脉（66.7% vs. 44.4%，p = 0.011）。DSCT和TTE在测量左心房、左心室、右心房和右心室大小方面具有良好的一致性（偏差分别为0.3 +/- 5.05 mm、-0.3 +/- 4.50 mm、5.8 +/- 14.15 mm和1.1 +/- 5.95 mm）。DSCT能为APVC患者提供最佳和准确的解剖细节，并作为TTE后的一种有前途的辅助成像方式，以实现更好和更全面的术前影像学评估。
Purpose: To evaluate the image features and diagnostic agreement for anomalous pulmonary venous connection (APVC) by dual-source computed tomography (DSCT) before surgery when compared with trans-thoracic echocardiography (TTE).Materials and methods: A total of one hundred and twenty-three patients were enrolled in this study. The associated malformation was analyzed between 39 total anomalous pulmonary venous connections (TAPVC) and 84 partial anomalous pulmonary venous connections (PAPVC). For 75 patients who received surgical treatment, the diagnostic agreement between the surgical findings of DSCT and TTE was evaluated. The dimensions of the four chambers of the heart were also measured by DSCT and TTE.Results: Atrial septal defect is the most common anomaly associated with APVC (86/123, 69.9%), which has a higher incidence in TAPVC compared to that in PAPVC (100% vs. 56.0%, p < 0.001). Of 75 operative patients, discrepancies in diagnostic sensitivity existed between DSCT and TTE for different drainage sites, supracardiac (94.4% vs. 82.2%, p= 0.001), cardiac (98.7% vs. 91.1%, p= 0.089), and infracardiac (100% vs. 57.1%, p = 0.096), respectively, and for different venous origins, right superior pulmonary vein (98.4% vs. 87.1%, p = 0.871), right inferior pulmonary vein (100% vs. 87.3%, p = 0.006), left superior pulmonary vein (100% vs. 93.1%, p= 0.246), left inferior pulmonary vein (100% vs. 95.7%, p= 0.500), and atypical pulmonary vein (66.7% vs. 44.4%, p = 0.011), respectively. Good agreement was obtained between DSCT and TTE for measurements of left atrium, left ventricle, right atrium, and right ventricle sizes (bias 0.3 +/- 5.05 mm, -0.3 +/- 4.50 mm, 5.8 +/- 14.15 mm, and 1.1 +/- 5.95 mm, respectively).Conclusions: DSCT can provide optimal and accurate anatomy details for patients with APVC, and serves as a promising accessary imaging modality after TTE to achieve a better and comprehensive preoperative imaging evaluation.