Diagnostic Value Of MSCT In The Aortic Root Diseases (581 Cases Analysis)

Objective:To study the diagnosis value of Multi-Slice spiral CT (MSCT) enhancing scan and post-processing technology in the aortic root diseases, in order to improve the knowledge and diagnostic accuracy.Methods:Five hundred and eighty-one patients with the aortic root diseases have been collected in the Affiliated Hospitals of Zunyi Medical College and the People's Hospital of GuiZhou during 2005-2010, and all patients were scanned by MSCT and confirmed by operation. The surgical results were set as the gold standard, and the diagnostic value of MSCT in the aortic root diseases was evaluated. Combining with clinical history, signs and other related inspection, the consistency and difference between preoperative MSCT diagnosis and the operative results were studied respectively, and CT features and the leakage/misdiagnosed reasons have been analyzed. Relevant data was collected for statistical analysis.Results:The results of MSCTOf the 581 cases with MSCT examination, no any abnormalities were found in 34 patients,133 patients were diagnosed as with congenial diseases (involving 280malformations), and 414 patients with acquired diseases. In the congenital diseases group, the single deformity was diagnosed in 21 cases, including 9 cases with ventricular septal defect,3 cases with the abnormal number of aortic valve and anatomical variations of coronary artery,2 cases with aorto-pulmonary septal defect and aortic sinus aneurysm, 1 case with subvalvular aortic stenosis and coronary artery aneurysm.The complex congenital heart disease (CCHD) was found in 112 cases, including 29 cases with tetralogy of Fallot,20 cases with double outlet right ventricle+ventricular septal defect, 16 cases with truncus arteriosis+ventricular septal defect,11 cases with Marfan's syndrom,10 cases with transportation of the great artery+ventricular septal defect,7 cases with hypoplastic left heart syndrome,5 cases with anatomical variations of coronary artery +an abnormal number of aortic valve,4 cases with aorto-pulmonary septal defect+ ventricular septal defect and tetralogy of Fallot+anatomical variations of coronary artery, 2 cases with transportation of the great artery+ventricular septal defect+anatomical variations of coronary artery,1 cases with supravalvular aortic stenosis,truncus arteriosis+ventricular septal defect+single ventricle,double outlet right ventricle+ ventricular septal defect+transportation of the great artery,aortico-left ventricular tunnel +ventricular septal defect+an abnormal number of aortic valve,aortico-right ventricular tunnel+ventricular septal defect.Of the 581 cases, the acquired diseases were 414, including 181 cases with the aortic dissection (typeⅠandⅡ),61 cases with aortic aneurysm,10 cases with intramural hematoma,78 cases with aortic valve diseases.84 cases with mitral valve diseases.The results of operationOne hundred and forty-six cases with congenital diseases were conformed by operation, with 296 malformations, and among them,15 malformations were missed by MSCT diagnosis, including 5 cases with Marian's syndrome,4 cases with ventricular septal defect,2 cases with congenital mitral valve diseases and congenital aortic valve diseases,1 cases with aorto-pulmonary septal defect,anatomical variations of coronary artery. Four hundred and thirty-five cases were diagnosed as acquired diseases by operation, and 21 cases were missed by MSCT diagnosis, including 9 cases with aortic valve diseases and 12 cases with mitral valve diseases.The contrastive analysis results between two groupsAmong the 581 patients, MSCT positive results were found in 547 cases before operation. The sensitivity,the rate of leakage,specificity,the misdiagnosed,coincidence rate of congenital diseases of MSCT were 91.10%,8.90%,100%,0%,97.76% respectively, with 15 malformations missed by MSCT. By contrast, the sensitivity,the rate of leakage,specificity,the misdiagnosed,coincidence rate of congenital diseases of acquired diseases were 95.17%,4.83%,100%,0%,96.39% respectively, with 21 diseases missed by MSCT. Conclusion:MSCT enhanced scan and post-processing technology can accurately display the aortic root and adjacent structures and diseases, and provide important information for clinical diagnosis,operative plan and postoperative follow-up. However, there are limited in the small defect,valvular diseases display, so it is necessary for MSCT to combine with ultrasonography,angiography sometimes.