多層螺旋CT 在小兒川崎病冠狀動(dòng)脈
損害中的應(yīng)用價(jià)值
侯陽 郭文力 于憲一 王虹 岳勇 陳麗英 郭啟勇
【摘要】 目的 評(píng)價(jià)多層螺旋CT( MSCT) 在小兒川崎病冠狀動(dòng)脈損害中應(yīng)用的可行性及價(jià)值。
方法 34 例川崎病患兒進(jìn)行16 層或64 層CT 冠狀動(dòng)脈增強(qiáng)掃描, 其中18 例有同期二維超聲心動(dòng)圖
檢查對(duì)照。計(jì)算各支冠狀動(dòng)脈的顯示情況。觀察病變形態(tài), 測(cè)量左、右冠狀動(dòng)脈主干的直徑, 計(jì)算
2 種方法的相關(guān)系數(shù)。結(jié)果 除4 例左旋支及8 例右冠狀動(dòng)脈中段顯示不清外, 其余冠狀動(dòng)脈均可
清楚顯示。MSCT 發(fā)現(xiàn)34 例患者中, 14 例有冠狀動(dòng)脈損害, 共22 支冠狀動(dòng)脈受累。冠狀動(dòng)脈主干擴(kuò)
張6 例, 主干擴(kuò)張伴動(dòng)脈瘤形成3 例, 主干未擴(kuò)張而中遠(yuǎn)段有動(dòng)脈瘤形成2 例, 冠狀動(dòng)脈狹窄1 例, 鈣
化2 例, 串珠狀改變3 例。MSCT 及二維超聲在冠狀動(dòng)脈主干測(cè)量值上差異無統(tǒng)計(jì)學(xué)意義( P >
0. 05) , 左、右冠狀動(dòng)脈主干測(cè)量值的相關(guān)系數(shù)分別為0. 85、0. 91( P < 0. 05) 。3 例右冠狀動(dòng)脈中遠(yuǎn)段
的動(dòng)脈瘤及1 例冠狀動(dòng)脈狹窄超聲未發(fā)現(xiàn)。2 例輕至中度二尖瓣反流及5 例血管壁增厚MSCT 未發(fā)
現(xiàn)。結(jié)論 MSCT 用于探查小兒川崎病冠狀動(dòng)脈損害是可行的, 可以作為心臟超聲的補(bǔ)充和替代方
法用于川崎病冠狀動(dòng)脈損害的診斷及隨訪。
【關(guān)鍵詞】 黏膜皮膚淋巴結(jié)綜合征; 冠狀血管; 體層攝影術(shù), X 線計(jì)算機(jī)
Noninvasive detection of coronary abnormalities in pediatr ic patients with Kawasaki disease using
multi-slice spir al CT HOU Yang, GUO Wen-li, YU Xia n-yi, WANG Hong, YUE Yong, CHEN Li-ying,
GUO Qi-yong. Department of Rediology, Shengjing Hospital, China Medical University, Shenyang 110004,
China
【Abstra ct 】 Objective To evaluate the feasibility and value of detecting coronary artery lesions in
Kawasaki disease using multi-slice computed tomography ( MSCT) . Methods Thirty-four pediatric patients
underwent 16-slice or 64-slice CT coronary angiography. 18 patients were also examined with 2 dimension
echocardiography ( 2DE) . In all cases, visibility of coronary artery segment was recorded . The diameter of
the LCA, RCA were measured in MSCTA and compared with 2DE. Correlation coefficient of dimension and
coincidence rate of two methods were calculated. Results Coronary artery lesions were found in 14 patients
( 22 branches ) of the 34 cases with KD on MSCT. Six cases were dialated, 3 cases were dialated with
aneurysms, 2 cases had aneurysms without dialation. Coronary artery stenosis in 1 cases, calcification in
2 cases. Three cases had multiple aneurysms with the presence of alternate stenosis that made the artery a
bead-like appearance. CC of LM and RCA were 0. 85, 0. 91, respectively( P > 0. 05) . Three coronary artery
aneurysm in the distal RCA was missed by 2DE. MSCT could not detect slight or moderate mitral
regurgitation in 2 patients and artery wall thickening in 5 patients. Conclusion MSCT would be an effective
complementary or alternative method for CDEC to evaluate coronary artery lesions non-invasively in pediatric
patients with Kawasaki disease.
【Key wor ds】 Mucocutaneous lymph node syndrome; Coronary vessels; Tomography X-ray
computed

多層螺旋CT 在小兒川崎病冠狀動(dòng)脈--心血管.rar