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双源CT在检测儿童川崎病冠状动脉
损害中的应用

赵立健1，韩波1，王锡明2，晁宝婷2，张建军1，庄建新1，张仪1   

  1. (1. 山东大学附属省立医院儿科， 济南 250021； 2. 山东省影像学研究所放射科， 济南 250021)
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-01-16 发布日期:2009-01-16
  • 通讯作者: 韩波

Dual source CT in detection of coronary artery lesions in
children with kawasaki disease

ZHAO Lijian1， HAN Bo1， WANG Ximing2， CHAO Baoting2，
ZHANG Jianjun1， ZHUANG Jianxin1， ZHANG Yi1
   

  1. （1. Department of Pediatrics, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China;
    2. Department of Radiology, Shandong Institute of Medical Imaging, Jinan 250021, China）
  • Received:1900-01-01 Revised:1900-01-01 Online:2009-01-16 Published:2009-01-16
  • Contact: HAN Bo

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摘要：
目的评价双源CT在检测儿童川崎病（KD）并冠状动脉损害（CAL）方面的临床应用价值。方法对15例确诊为KD并经心脏超声确诊合并CAL的患儿进一步行双源CT（DSCT）检查，观察其冠状动脉病变的程度和冠状动脉瘤的数目、位置、形态和大小，并和同期超声心动图进行比较分析。结果DSCT共检测到冠状动脉瘤43个，肿瘤最宽径1.55?cm，平均（0.65±0.47）cm，其中小冠状动脉瘤（＜0.4?cm）15个，中冠状动脉瘤（＜0.8?cm，≥0.4?cm）20个，巨大冠状动脉瘤（≥0.8?cm）8个。累及左冠状动脉21个，包括左冠主干9个，前降支近段4个，前降支中段5个，回旋支3个。累及右冠状动脉22个，包括右冠近段9个，右冠中段7个，右冠远段6个。另外，发现3处狭窄及2处血栓形成。而6个位于中远段的冠状动脉瘤、2处血栓及3处狭窄B超未能显示。结论DSCT能清晰显示川崎病患儿冠状动脉病变的情况，在显示局部冠状动脉狭窄和血栓形成方面明显优于经胸超声，可成为川崎病并冠状动脉瘤患儿诊断和随访的重要评估方法。

关键词: 双源, 体层摄影术,X线计算机, 川崎病, 冠状动脉瘤

Abstract: To evaluate the value of dual source CT(DSCT) in diagnosis of coronary artery lesions due to kawasaki disease in children. MethodsFifteen children with known kawasaki disease and coronary artery lesions confirmed by echocardiography underwent coronary artery angiography by DSCT. The number, location, shape and size of each coronary artery aneurysm was recorded and compared with those determined by echocardiography. ResultsThere were 8 males and 7 females with a mean age of 3 years and 2 months (range 2 months to 11 years). A total of 43 coronary artery aneurysms were found by DSCT, and the maximum diameter of which was 1.55cm (mean 0.65±0.47cm). 15 aneurysms were small in size, 20 aneurysms were medium in size and 8 were giant aneurysms. Among the aneurysms in the left coronary artery, 9 were located in the left main trunk, 4 were located in the proximal segment of the left anterior descending branch(LAD), 5 were located in the medium segment of the LAD, and 3 were located in the left circumflex branch. 22 coronary artery aneurysms were located in the right coronary artery, including 9 in the proximal segment, 7 in the medium segment and 6 in the distal segment. 3 stenotic segments and 2 thrombus were additionally found. 6 aneurysms located in the medium or distal segments, 3 stenotic and 2 thrombus were not found by echocardiography. ConclusionDSCT can clearly visualize coronary artery lesions due to kawasaki disease in children, especially in detection of the stenotic segments and thrombosis.

Key words: Dual source, Tomography,XRay computed, Kawasaki disease, Coronary artery aneurysm

中图分类号: 

  • R725.4
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