ABSTRACT
Objective To explore the value of multislice CT (MSCT)in the diagnosis of complex congenital heart disease (FCHD)in children.Methods 41 children cases with clinical diagnosis of congenital heart disease were collected randomly.All the children were examined with MSCT and ultrasonic cardiogram(UCG)examination,and 20 cases were examined with cadioangiography(CAG) check.All the cases were confirmed by surgery.The results of Preoperative MSCT,UCG and the CAG heart examination diagnosis were compared with surgical diagnosis results.Results Surgery confirmed 225 deformities and 1 1 5 intracardiac malformations.In the intracardiacmal malformations,the accurate diagnostic rates of MSCT,UCG,the CAG were 92.2%,99.1% and 74.4%,respectively;With surgery confirmed 110 heart malformations,the accurate diagnostic rates of MSCT,UCG,the CAG were 98.2%,84.5%,96.2%,respec-tively.The combined use of MSCT and UCG confirmed 224 correct diagnoses,the diagnosis coincidence rate reached 99.6%;The check accuracy of MSCT was highter than UCG in congenital heart disease with heart malformations(χ2 =12.962,P <0.05),The differences has statistical significance.Conclusion The check accuracy of MSCT is better in the diagnosis of congenital heart disease.The joint application of MSCT and UCG can obviously improve the accuracy of the diagnosis of congenital heart disease and congenital anoma-lies.
ABSTRACT
[Objective] To investigate the anatomical relation between manubrium sternum incisure(MSI)with the level of upper thoracic vertebrae(UTV)and to find out the basis of operative approach of UTV.[Method]Standing pan chest radiographs of 400 male and 400 female were equally divided into 4 year groups:≤19 years,20～39 years,40～59 years and ≥60 years and were used to observe the relationship between MSI with the level of UTV.On the basis of this relationship,a suitable UTV approach was advocated.There were fracture and dislocation of UTV 7 cases,UTV tumor 9 cases,tuberculosis of UTV 3 cases;OPLL ossification of UTV 2 cases.Diseases located at T1 6 cases,T2 7 cases,T3 2 cases,T4 3 cases,T1、2 2 cases,T2、3 1 case.Lower anterior cervical approach was performed for 7 cases including T1、2 one case and T2 one case,improved T3 1 case,and right subscapular transthoracic posterolateral approach was used for 5 cases.[Result]The number of UTV in relationship with the level of MSI was successively increased from T1 to T3 and was gradually decreased on T4,i.e.rate of cases of level of MST in relationship with T1、2 level was 1%,to T2 level 5.5%,to T2、3 level 15.87%,to T3 level 43.5%,to T3、4 level 20.75%,to T4 13.375%.No relationship was found in trend of distribution with the age and gender.The operative approach of UTV according its relationship with MSI was performed with the advantages of satisfactory exposure easily manipulation and satisfactory clinic results in most follow-up cases.One case died of metastasis of tumor in 9 months,3 cases were complicated with cerebrospinal fluid leakage and 3 cases with injury of recurrent laryngeal nerve.[Conclusion]Approach to UTV should be selected according to its relationship between MSI and diseased UTV preoperatively.The operative approach of UTV according to its relationship with MST has the advantages of satisfactory exposure,easily manipulation and satisfactory clinic results.