The Diagnostic Value Of Multislice Spiral Computed Tomography In Neonates And Infants With Tetralogy Of Fallot

ObjectivesTetralogy of Fallot (TOF) is one of the most common Cyanotic Congenital Heart Disease (CHD). It holds about 80% of Cyanotic Congenital Heart Disease,about 10% of all kinds of Congenital Heart Disease, about 50%-90% of complex Congenital Heart Disease, The diagnostic methods we have now including TTE (Transthoracic Echocardiography),ACG(Angiocardiography),EBCT(Electron Beam Computed Tomography),MRI (Magnetic Resonance Imaging) and MSCTA (Multislice Spiral Computed Tomography Angiography) ,et al. ACG is normally considered as the gold standard method of TOF. MSCTA as a diagnostic method of CHD has many advantages such as safe, noninvasive and fast. Nowadays there have some literatures about the quality diagnostic value of MSCTA, but less thesis about the quantity diagnostic value of MSCTA. My thesis paid attention to the quantity diagnostic value of MSCTA before surgery. Analyzed the patients' status of TOF which got by both MSCTA and TTE, in order to offer a quick and accuracy diagnostic method for TOF.Materials and Methods1. ObjectExperimental group: 65 cases 0-3 years old neonates and infants with Tetralogy of Fallot whom was certified by surgery and had examined by MSCTA and TTE in The Third Affiliated Hospital of Zhengzhou University between July 2007 and November 2008.Control group: 54 cases 0-3 years old neonates and infants with Ventricular Septal Defect whom was certified by surgery and had examined by MSCTA in The Third Affiliated Hospital of Zhengzhou University between July 2007 and November 2008.2. MethodExamine the patient with MSCTA by GE Lightspeed 16 slices spiral CT. Then analyze, diagnose and measure images in workstation ADW 4.2 by all kinds of reformation methods and calculate McGoon Index and Nakata Index.Examine the patient with TTE by GE Vivid 7 PRO color Doppler ultrasound instrument. Measure the width of VSD, the inner diameter of pulmonary and descending aorta. Calculate McGoon Index and Nakata Index.3. Statistical analysisSPSS16.0 statistical packages on the measurement data for statistical analysis, using mean, standard deviation, single-factor analysis of variance and X~2 text (α=0.05).Results1. The inner diameters in different parts of patients with TOF measured by MSCT or TTE have no statistical difference (P>0.05).2. The inner diameters of different parts of pulmonary artery of patients with TOF or VSD have statistical difference (P<0.05).3. There is no statistical difference in display proximal end of pulmonary artery between MSCT and TTE(P>0.05). There has statistical difference in display distal end of pulmonary artery between MSCT and TTE (P<0.05).Conclusions1. MSCTA can not only make good diagnostic of qualitation but also make accurate diagnostic of quantitation, it has great mean to the choice of surgery and the evaluation of prognosis.2. MSCTA is a diagnostic method of CHD with safe, noninvasive, fast and accurate. It can almost instead of TTE and it is better than TTE in display extra-cardiac arteries like pulmonary artery.