双源CT冠状动脉成像在卵圆孔未闭中的诊断价值
The value of dual source coronary CT angiography in diagnosis of patent foramen ovale
刘乙锦 1郑冲 2耿文磊 2孙丽杰 3李静 3卢洁4
作者信息
- 1. 首都医科大学宣武医院放射与核医学科 北京 100053
- 2. 磁共振成像脑信息学北京市重点实验室 北京 100053
- 3. 首都医科大学宣武医院老年医学科 北京 100053
- 4. 首都医科大学宣武医院放射与核医学科 北京 100053;磁共振成像脑信息学北京市重点实验室 北京 100053
- 折叠
摘要
目的 探讨双源 CT 冠状动脉成像(coronary CT angiography,CCTA)对卵圆孔未闭(patent foramen ovale,PFO)的临床诊断价值.方法 选取临床怀疑为PFO患者 99 例,均接受CCTA和经食管超声心动图(transesophageal echocardiography,TEE)检查,以TEE检查结果作为诊断金标准,CCTA测量原发隔所构成的卵圆孔瓣(free flap valve,FV)的长度,PFO宽度、高度,继发隔(interatrial groove,IAG)的长度、厚度以及卵圆窝(oval fossa,FO)直径.结果 99 例患者中,CCTA检查发现PFO 82 例.其中,无分流者占PFO患者的 30.5%,Ⅰ级分流占 42.7%,Ⅱ级分流占 20.7%,Ⅲ级分流占 6.1%.FV上下长度为(1.23±0.28)cm,PFO宽度为(1.19±0.46)cm,高度为(0.17±0.04)cm,PFO通道右心房入口宽度为(0.18±0.08)cm,IAG厚度为(0.74±0.23)cm,长度为(1.58±0.41)cm,FO的直径为(1.41±0.39)cm.CCTA检测 PFO的灵敏度为 92.1%,特异度为 100%,准确度为 92.9%,阳性预测值为 100%,阴性预测值为 58.8%,Kappa值为 0.892.结论 CCTA 可显示PFO的精细解剖结构及分流情况,为PFO患者封堵术前评估提供影像学依据.
Abstract
Objective To evaluate the value of dual-source coronary CT angiography(CCTA)in the diagnosis of patent fora-men ovale(PFO).Methods The clinical data of 99 suspected patients with PFO were retrospectively collected and analyzed.The assessment of PFO by CCTA was determined and compared with the assessment by TEE as the gold standard.Dual source CT was used to measure the length of the free flap valve(FV)consisting of the primary septum,the width of the PFO,the height of the PFO,the length of the secondary septum,the thickness of the secondary septum,and the diameter of the oval fossa(FO).Results Among the 99 patients,PFO was found in 82 patients accounting for 82.8％of the total patients.Among them,30.5％of patients presented without shunts and 69.5％of patients with shunts.Furthermore,42.7％presented with grade Ⅰ shunt,20.7％with grade Ⅱ shunt,and 6.1％with grade Ⅲ shunt.The FV was(1.23±0.28)cm,the width of PFO was(1.19±0.46)cm,the height was(0.17±0.04)cm,the width of right atrium entrance of PFO channel was(0.18±0.08)cm,the thickness of IAG was(0.74±0.23)cm,the length was(1.58±0.41)cm,and the diameter of FO was(1.41±0.39)cm.Among the 99 pa-tients,PFO was found in 89 patients by TEE.The sensitivity,specificity,accuracy,positive predictive value,and negative pre-dictive value of CCTA for detecting PFO were 92.1％,100％,92.9％,100％,and 58.8％,respectively.In the PFO diagnosis,the CCTA and TEE results were highly consistent,with a Kappa value of 0.892.Conclusion This study finds that CCTA examina-tion can provide anatomical details on the size and morphologic features of PFO and its shunts,thereby offering the evaluation be-fore PFO occlusion with imaging evidence.
关键词
卵圆孔未闭/心血管造影/体层摄影术,X线计算机Key words
Patent foramen ovale/Angiocardiography/Tomography,X-ray computed引用本文复制引用
基金项目
首都医科大学宣武医院"汇智"人才工程学者计划项目(HZ2021ZCLJ005)
出版年
2024
NETL
NSTL
万方数据