ABSTRACT
Objective To explore the value of MSCT in diagnosis of pulmonary atresia complicated with ventricular septal defect (PA/VSD).Methods Clinical and imaging data of 81 patients with PA/VSD were retrospectively analyzed.All patients underwent transthoracic echocardiography (TTE) and MSCT before surgical operation,and the imaging data were compared with surgical findings.Results There were 23 patients of type A1,17 of type A2,34 of type B and 7 of type C PA/VSD.The accuracy rate of MSCT classification of PA/VSD (93.82％ [76/81]) was higher than that of TTE (59.26％ [48/81];x2=26.95,P＜0.01).The accuracy rate of MSCT diagnosis of origin of major aortopulmonary collateral arteries (MAPCAs,100％ [93/93]) was higher than that of TTE (51.84％ [51/93];x2 =54.25,P＜0.01).Fifty cardiac malformations (50/53,94.34％) were detected with MSCT,53 with TTE ([53/53,100％];x2 =1.37,P=0.24),while 66 heart-vessel conjunction abnormalities (66/66,100％) were detected with MSCT,and 65 with TTE ([65/66,98.48％],P＞0.05).Meanwhile,106 extracardiac great vessel abnormalities (106/106,100％) were detected with MSCT and 87 with TTE ([87/106,82.08％],x2 =20.87,P＜0.05).McGoon index,pulmonary artery index and total neo-pulmonary arterial indexes (TNPAI) measured with MSCT were not statistical different with findings of surgical operation (all P＞ 0.05).Conclusion MSCT can accurately diagnose type of PA/VSD and display pulmonary artery developmental state,therefore providing guidance for clinical treatment of PA/VSD.
ABSTRACT
Objective@#To explore the diagnosis value of late gadolinium enhancement(LGE) detected by magnetic resonance imaging(MRI) in acute myocardial infarction(AMI) patients.@*Methods@#The clinical and MRI data of 52 AMI patients hospitalized from January 2016 to July 2017 in our hospital were retrospectively analyzed. All patients received medication and revascularization therapies after admission and cardiac magnetic resonance examination was performed within 1 week after admission. According to whether there was LGE, AMI patients were divided into LGE(+) group(33 cases) and LGE(-) group(19 cases). According to the existence of microvascular obstruction(MVO) and/or intramyocardial hemorrhage(IMH),LGE(+) patients were divided into MVO/IMH(+) group(18 cases) and MVO/IMH(-) group(15 cases).@*Results@#(1)There were no statistical significance between the LGE(+)group and LGE(-)group in the age, gender,smoking history, hypertension, diabetes mellitus, dyslipidemia, ventricular arrhythmia, culprit vessel, left ventricular end-diastolic volume(LVEDV), and left ventricular end-systolic volume(LVESV) (all P>0.05). The left ventricular ejection fraction was significantly lower in LGE(+) group than in LGE(-) group( (38.7±17.6) % vs. (51.2±7.9)%, P=0.001). (2)The infarct size was positively correlated with LVEDV and LVESV(r=0.436,P=0.011;r=0.479,P=0.005,respectively), and negatively correlated with left ventricular ejection fraction (r=-0.641, P<0.001) in LGE(+) group. (3) The infarct size, LVEDV, and LVESV were significantly higher in MVO/IMH(+) group thanin MVO/IMH(-) group ((26.5±7.3)%vs. (16.2±8.3)%, P=0.001; (145.7±40.9)ml vs. (112.2±23.8)ml,P=0.009; (90.0±30.8)ml vs. (61.4±19.0)ml,P=0.004, respectively), and the left ventricular ejection fraction was significantly lower in MVO/IMH(+) group than in MVO/IMH(-) group ((29.8±15.0)% vs. (49.3±14.5)%, P=0.001).@*Conclusions@#LGE detected bycardiac magnetic resonance can provide useful information on the myocardial necrosis extent of AMI patients. Presence of MVO/IMH in LGE(+) patients is linked with larger infarct size and worse cardiac dysfunction in AMI patients.