目的:探讨双源CT在川崎病冠状动脉瘤的诊断价值,并与超声心动图检查结果进行对比分析.方法:回顾性分析某院2008年3月至2010年7月临床确诊50例川崎病患者的双源CT影像资料,观察冠状动脉瘤好发部位、扩张程度以及冠状动脉瘤的形态、大小、位置和数目,对于超声心动图检查的影像资料进行对比分析.结果:50例患者中双源CT共检出116个瘤体,近段瘤体共计56个,发现率为48.28％；中段瘤体共计36个,发现率为31.03％；远段瘤体共计14个,发现率为13.79％；前降支瘤体共计40个,发现率为34.48％；回旋支瘤体共计12个,发现率为10.34％；右冠支瘤体共计58介,发现率为50％;左主干瘤体共计6个,发现率为5.17％；其中瘤体内附壁血栓共24个.超声心动图共检出42个瘤体,漏诊6例.结论:双源CT可显示冠状动脉全程支段,对于瘤体数量、位置、大小、瘤体内钙化或血栓检出率均高于超声心动图,因超声心动图具有安全、简便、费用低、可靠的优势,重复动态观察冠状动脉扩张及其演变的全过程可用于初步的筛查,如两者结合检查,诊断准确率可明显提高,可作为治疗随访的最佳手段.%Objective To investigate the value of dual-source CT for Kawasaki Disease with coronary artery aneurysm and perform comparison analysis with echocardiography. Methods Fifty cases of Kawasaki disease from March 2008 to July 2010 in Xijing Hospital were analyzed retrospectively for their dual -source CT data. The predilection site, dilation degree, morphology, size, location and number of the coronary artery aneurysm were observed, which were compared with the results by echocardiography. Results One hundred and sixteen pieces of aneurysms were found in the 50 patients fay dual-source CT, of which, there were 48.2% or 56 ones of proximal aneurysms, 31.03% or 36 ones of middle—part aneurysms, and 13.79% or 14 ones of distal aneurysms. There were 34.48% or 40 ones of left anterior descending artery aneurysms, 10.34% or 12 ones of circumflex artery aneurysms, 50% or 58 ones of right coronary branch aneurysms, 5.17% or 6 ones of left main coronaiy artery aneurysms, and there were 24 cases of mural thrombus in the aneurysms. Echocardiography found 42 ones of aneurysms with 6 cases of misdiagnosis. Conclusion Dual—source CT shows its advantages in the detection of the aneurysms number, location, size, calcification and thrombus over echocardiography, while the latter is safe, convenient, low-cost and reliable and can be used for initial screening of coronary artery dilation. The combination of dual—source CT and echocardiography can improve the diagnostic accuracy and follow up greatly.
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