多層螺旋CT 在小兒川崎病冠狀動脈
損害中的應用價值
侯陽 郭文力 于憲一 王虹 岳勇 陳麗英 郭啟勇
【摘要】 目的 評價多層螺旋CT( MSCT) 在小兒川崎病冠狀動脈損害中應用的可行性及價值。
方法 34 例川崎病患兒進行16 層或64 層CT 冠狀動脈增強掃描, 其中18 例有同期二維超聲心動圖
檢查對照。計算各支冠狀動脈的顯示情況。觀察病變形態, 測量左、右冠狀動脈主干的直徑, 計算
2 種方法的相關系數。結果 除4 例左旋支及8 例右冠狀動脈中段顯示不清外, 其余冠狀動脈均可
清楚顯示。MSCT 發現34 例患者中, 14 例有冠狀動脈損害, 共22 支冠狀動脈受累。冠狀動脈主干擴
張6 例, 主干擴張伴動脈瘤形成3 例, 主干未擴張而中遠段有動脈瘤形成2 例, 冠狀動脈狹窄1 例, 鈣
化2 例, 串珠狀改變3 例。MSCT 及二維超聲在冠狀動脈主干測量值上差異無統計學意義( P >
0. 05) , 左、右冠狀動脈主干測量值的相關系數分別為0. 85、0. 91( P < 0. 05) 。3 例右冠狀動脈中遠段
的動脈瘤及1 例冠狀動脈狹窄超聲未發現。2 例輕至中度二尖瓣反流及5 例血管壁增厚MSCT 未發
現。結論 MSCT 用于探查小兒川崎病冠狀動脈損害是可行的, 可以作為心臟超聲的補充和替代方
法用于川崎病冠狀動脈損害的診斷及隨訪。
【關鍵詞】 黏膜皮膚淋巴結綜合征; 冠狀血管; 體層攝影術, X 線計算機
Noninvasive detection of coronary abnormalities in pediatr ic patients with Kawasaki disease using
multi-slice spir al CT HOU Yang, GUO Wen-li, YU Xia n-yi, WANG Hong, YUE Yong, CHEN Li-ying,
GUO Qi-yong. Department of Rediology, Shengjing Hospital, China Medical University, Shenyang 110004,
China
【Abstra ct 】 Objective To evaluate the feasibility and value of detecting coronary artery lesions in
Kawasaki disease using multi-slice computed tomography ( MSCT) . Methods Thirty-four pediatric patients
underwent 16-slice or 64-slice CT coronary angiography. 18 patients were also examined with 2 dimension
echocardiography ( 2DE) . In all cases, visibility of coronary artery segment was recorded . The diameter of
the LCA, RCA were measured in MSCTA and compared with 2DE. Correlation coefficient of dimension and
coincidence rate of two methods were calculated. Results Coronary artery lesions were found in 14 patients
( 22 branches ) of the 34 cases with KD on MSCT. Six cases were dialated, 3 cases were dialated with
aneurysms, 2 cases had aneurysms without dialation. Coronary artery stenosis in 1 cases, calcification in
2 cases. Three cases had multiple aneurysms with the presence of alternate stenosis that made the artery a
bead-like appearance. CC of LM and RCA were 0. 85, 0. 91, respectively( P > 0. 05) . Three coronary artery
aneurysm in the distal RCA was missed by 2DE. MSCT could not detect slight or moderate mitral
regurgitation in 2 patients and artery wall thickening in 5 patients. Conclusion MSCT would be an effective
complementary or alternative method for CDEC to evaluate coronary artery lesions non-invasively in pediatric
patients with Kawasaki disease.
【Key wor ds】 Mucocutaneous lymph node syndrome; Coronary vessels; Tomography X-ray
computed

多層螺旋CT 在小兒川崎病冠狀動脈--心血管.rar