上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (12): 1540-.doi: 10.3969/j.issn.1674-8115.2010.12.022

• 论著（临床研究） • 上一篇    下一篇

低剂量双源CT在儿童川崎病冠状动脉病变诊断中的应用

金 彪   

  1. 上海交通大学 医学院附属新华医院崇明分院放射科, 上海 202150
  • 出版日期:2010-12-25 发布日期:2010-12-31
  • 作者简介:金 彪（1969—）, 男, 副主任医师, 博士；电子信箱: king1969@hotmail.com。

Application of low-dose dual-source CT in diagnosis of coronary lesions in patients with Kawasaki disease

JIN Biao   

  1. Department of Radiology, Xinhua Hospital (Chongming Branch), Shanghai Jiaotong University School of Medicine, Shanghai 202150, China
  • Online:2010-12-25 Published:2010-12-31

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摘要：

目的 探讨低剂量双源CT在儿童川崎病冠状动脉病变诊断中的应用价值。方法 对38例确诊的川崎病患儿（男29例，女9例，平均年龄3.4岁）行冠状动脉双源CT血管成像；其中屏气组（n=8）采用心电门控冠状动脉扫描，无屏气组（n=30）用常规胸部螺旋扫描，电压恒定为80 kV。统计冠状动脉瘤的数量、部位和大小，并与同期超声心动图检查结果进行比较；计算患儿所受的电离辐射量。结果 共检出冠状动脉瘤47个，平均直径(8.4±3.5) mm，平均长度(13.8±7.4) mm。47个冠状动脉瘤中，小型、中型和巨大型分别为10个、15个和22个。位于左冠状动脉主干、近段、中段和旋支的动脉瘤分别为8个、13个、5个和6个；位于右冠状动脉近段、中段和远段的动脉瘤分别为8个、6个和1个。共检出10个狭窄段，8个冠状动脉瘤有钙化。平均辐射剂量为(0.46±0.24) mSv。超声心动图未检出位于中段和远段的5个小型动脉瘤。结论 双源CT对川崎病患儿冠状动脉病变的诊断有很高的价值，是超声心动图很好的补充。

关键词: 双源CT, 辐射剂量, 冠状血管, 川崎病

Abstract:

Objective To investigate the value of low-dose dual-source CT in the diagnosis of coronary lesions in patients with Kawasaki disease. Methods Thirty-eight children (29 boys and 9 girls) diagnosed as Kawasaki disease underwent coronary CT angiography using dual-source CT. ECG-gated coronary acquisition were applied in 8 patients who could hold breath, and non-ECG-gated conventional thoracic spiral CT were used in 30 patients who could not hold breath. A setting of 80 kV in voltage was implemented. The number, location and size of coronary aneurysms were recorded, and were compared with echocardiographic findings. The radiation doses of patients were calculated. Results A total of 47 coronary aneurysms were demonstrated, with mean diameter of (8.4±3.5) mm and mean length of (13.8±7.4) mm. Ten aneurysms were small, 15 were medium and the other 22 were giant in size. Among the aneurysms in left coronary artery, 8, 13, 5 and 6 were located in the main branch, proximal segment, middle segment and circumflex branch, respectively. Among the aneurysms in right coronary artery, 8, 6 and 1 were located in the proximal, middle and distal segment, respectively. Ten stenotic segments were demonstrated, with calcification in 8 aneurysms. The mean radiation dose was (0.46±0.24)mSv. Echocardiography failed to detect 5 small aneurysms located in the middle and distal segment of coronary arteries. Conclusion Dual-source CT is an useful tool in the diagnosis of coronary lesions in patients with Kawasaki disease, and is a supplement to echocardiography.

Key words: dual-source CT, radiation dosage, coronary vessels, Kawasaki disease