多层螺旋CT 在小儿川崎病冠状动脉
损害中的应用价值
侯阳 郭文力 于宪一 王虹 岳勇 陈丽英 郭启勇
【摘要】 目的 评价多层螺旋CT( MSCT) 在小儿川崎病冠状动脉损害中应用的可行性及价值。
方法 34 例川崎病患儿进行16 层或64 层CT 冠状动脉增强扫描, 其中18 例有同期二维超声心动图
检查对照。计算各支冠状动脉的显示情况。观察病变形态, 测量左、右冠状动脉主干的直径, 计算
2 种方法的相关系数。结果 除4 例左旋支及8 例右冠状动脉中段显示不清外, 其余冠状动脉均可
清楚显示。MSCT 发现34 例患者中, 14 例有冠状动脉损害, 共22 支冠状动脉受累。冠状动脉主干扩
张6 例, 主干扩张伴动脉瘤形成3 例, 主干未扩张而中远段有动脉瘤形成2 例, 冠状动脉狭窄1 例, 钙
化2 例, 串珠状改变3 例。MSCT 及二维超声在冠状动脉主干测量值上差异无统计学意义( P >
0. 05) , 左、右冠状动脉主干测量值的相关系数分别为0. 85、0. 91( P < 0. 05) 。3 例右冠状动脉中远段
的动脉瘤及1 例冠状动脉狭窄超声未发现。2 例轻至中度二尖瓣反流及5 例血管壁增厚MSCT 未发
现。结论 MSCT 用于探查小儿川崎病冠状动脉损害是可行的, 可以作为心脏超声的补充和替代方
法用于川崎病冠状动脉损害的诊断及随访。
【关键词】 黏膜皮肤淋巴结综合征; 冠状血管; 体层摄影术, X 线计算机
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

多层螺旋CT 在小儿川崎病冠状动脉--心血管.rar