| Congenital heart disease (CHD) is one of the most common congenital malformation, and common pediatric cardiovascular disease. It affects seriously pediatric physical and mental health. The majority of children with congenital heart diseases come to premature end in neonatal period or in infantile age. Detection as soon as possible and positive diagnosis has more important significance in improve the survival rate and survival mass of children with congenital heart diseases. Modern cardiovascular imaging not only provide the information of cardiovascular morphology and anatomy, but also the information of cardiac function and myocardial wall motion, thus it acts an important instructional role of clinical advanced diagnosis.Objective:1. To study comparatively the accuracy of transthoracic echocardiography (TTE), cardiovascular digital imaging (CVDI), electron beam computed tomography (EBT) and magnetic resonance imaging (MRI) in the diagnosis of complex congenital heart diseases.2. To assess the clinical value of MRI, EBT and their postprocessing function.3. To evaluate comprehensively the value of TTE, MRI, EBT and CVDI in the diagnosis of complex congenital heart diseases.Materials and Methods:1. Materials: From August 1995 to April 2002, 231 patients with complex congenital heart diseases (143 boys and 88 girls) were enrolled in this study in Xi jing hospital. Patients' age ranged from 2 months to 25 years (mean age, 88 months). All of them were examined by two-dimensional echocardiography (2DE) and color Doppler flow imaging (CDFI), 227 cases of them were examined CVDI,-8-18 by EBT, and 3 by MRI. One hundred fifty-eight cases of them underwent surgery (95 boys and 63 girls), 156 cases of them underwent CVDI, 14 EBT, and 3 MRI. A comparison was made between the data obtained and surgical findings.2. Equipment and methods: (1) TTE: MK-600 ultrasound equipment of ATL company and HP-500 or 1500 color Doppler diagnostic apparatus were used. Patients were examined with multi-posture and multi-section by TTE. (2) EBT: Imatron C-150 scaning apparatus with Accuimage workstation and Accview software of Accuimage company was usd to abtain images. Patients were examined by enhanced volume scanning of across-axis and by cine rank scanning of across-axis or short-axis of heart, and then the obtained images were postprocessed.(3) MRI: Imaging was performed with Gyroscan Intera 1.5T MRI machine and Easyvision workstation of PHILIPS company. Patients were scanned by multi-posture and multi-section, and then the obtained images were postprocessed.(4) CVDI: Cardiovascular digital imaging was made with Polydoros 80A X-ray CAG machine of SIEMENS comopany, including Hicor digital imaging processing and Bicor "C"-arm. Right atrial angiography, right and left ventriclography, pulmonary artery angiography and aortography were made respectively by the route right femoral vein and/or right femoral artery using Selding tchnique.3. Statistical analysis: The primary data were processed with -i2 check and correlation analysis by SPSS 10.0 software.Results:1. One hundred fifty-eight cases of 231 patients with complex CHD underwent surgery. The accurate rate of TTE, CVDI and EBT in diagnosing complex CHD was 78.5% (124/158), 94.9% (148/156) and 85.7% (12/14) respectively. By -f-2 check, p< 0.01, the differnces among them are significant, the accurate rate of CVDI and EBT is higher than that of TTE.2. The rate of misdiagnosis and missed diagnosis of TTE was 12.7% (20/158) and 8.9% (14/158) in the diagnosis of complex CHD, the rate of misdiagnosis of CVDI was 5.1% (8/156), both of rates misdiagnosis and missed diagnosis for EBT were 7.1% (1/14),3. The accurate rates of diagnosis of TTE, CVDI and EBT in displaying the following malformation of complex CHD were 72.3% (229/317), 87.7% (278/317)-9-and 93.3% (28/31) respectively. By statistical analysis, P value is less than 0.01, the differnces among them were...
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