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目的探讨二代双源CT(Dual-source computed tomography,DSCT)在先天性三尖瓣畸形诊断中的应用价值。方法回顾性搜集经手术证实的40例三尖瓣畸形患者的DSCT及实时三维超声心动图(Real-time three-dimensional echocardiography,RT-3DE)诊断资料,比较DSCT扫描与RT-3DE诊断先天性三尖瓣畸形及其伴发畸形的结果符合率,采用卡方检验,P<0.05为有统计学意义,并对三尖瓣瓣叶的图像质量进行评分。结果 40例患者共计先天性三尖瓣畸形43处,有3例患者三尖瓣下移畸形合并三尖瓣发育不良,其中三尖瓣下移畸形32处,三尖瓣闭锁3处,三尖瓣发育不良5处,三尖瓣瓣叶数目异常(二叶式畸形及瓣叶大部分缺如)3处。对于先天性三尖瓣畸形,DSCT和RT-3DE的诊断准确率分别为90.70%(39/43),100%(43/43),两者无统计学意义(χ~2=4.20,P>0.05)。DSCT和RT-3DE对并发心内畸形的诊断准确率分别为82.86%(29/35)、100%(35/35),两者有统计学差异(χ~2=6.56,P<0.05);对并发心外畸形的诊断准确率分别为94.12%(16/17)、58.82%(10/17),两者有统计学差异(χ~2=5.89,P<0.05)。40例患者DSCT三尖瓣图像质量评分为(3.82±0.73)分。结论 DSCT对于先天性三尖瓣畸形及其合并其他畸形的诊断具有重要的价值。
Objective To investigate the value of dual-source computed tomography (DSCT) in the diagnosis of congenital tricuspid valve deformity. Methods The data of DSCT and real-time three-dimensional echocardiography (RT-3DE) in 40 patients with tricuspid valve deformity confirmed by surgery were retrospectively collected. The data of DSCT and RT-3DE in diagnosis of congenital trisomy The coincidence rate of the results of cusp deformity and concomitant deformity was analyzed by Chi-square test, P <0.05 was considered statistically significant, and the image quality of tricuspid valve leaflets was scored. Results Totally 40 cases of congenital tricuspid valve deformity were found in 40 cases. Tricuspid regurgitation and tricuspid valve dysplasia were found in 3 cases. Tricuspid regurgitation was 32, tricuspid atresia 3, 5 cases of dysplasia, abnormal number of tricuspid valve leaflets (bilobed deformity and most of the absence of valve leaflets) 3. For congenital tricuspid valve deformity, the diagnostic accuracy rates of DSCT and RT-3DE were 90.70% (39/43) and 100% (43/43) respectively, with no statistical significance (χ ~ 2 = 4.20, P> 0.05). The diagnostic accuracy rates of DSCT and RT-3DE were 82.86% (29/35) and 100% (35/35), respectively. There was a significant difference between them (χ ~ 2 = 6.56, P <0.05). The accuracy rate of diagnosis of complicated external malformations was 94.12% (16/17) and 58.82% (10/17), respectively. There was a significant difference between them (χ ~ 2 = 5.89, P <0.05). DSCT tricuspid image quality score was (3.82 ± 0.73) in 40 patients. Conclusions DSCT is of great value in the diagnosis of congenital tricuspid valve deformity and other deformities.