1、先天性心脏病及先天性心脏病及CT影像诊断影像诊断小儿综合内科小儿综合内科张伟张伟Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPAscending Aorta升主动脉Descending Aorta降主动脉Pulmonary Artery肺动脉Superior Vena Cava上腔静脉Left Coronary Artery(LCA)左冠状动脉Left Main Artery(LMA)左主干Left Anterior Descending(LAD)左前降支Left Marginal Branch(LMB)左边缘支Left Circumflex(L
2、CX)左回旋支Right Coronary Artery(RCA)右冠状动脉Posterior Descending Artery(PDA)后降支Conus Branch 动脉圆锥支Left Atrium 左心房Right Atrium 右心房Left Ventricle 左心室Right Ventricle 右心室Cardiac Vein 心脏静脉Mitral Valv 二尖瓣Coronary Sinus 冠状窦Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiP传统的影像学诊断方法有胸部X线、超声心动图、MRI、心导管造影检查 Cardiac An
3、atomyCardiac AnatomyGEMSC CT APPL TiPCardiac AnatomyCardiac AnatomyMDCT的优势的优势扫描时间短扫描时间短空间分辨力较高空间分辨力较高空间分辨力较高空间分辨力较高三维后处三维后处理重组理重组GEMSC CT APPL TiPAscending AortaPulmonary ArteryDescending AortaAscending AortaPulmonary ArteryDescending Aorta CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT
4、 APPL TiPAscending AortaPulmonary ArteryDescending AortaSuperior Vena CavaAscending AortaPulmonary ArteryDescending AortaSuperior Vena Cava CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPSuperior Vena CavaSuperior Vena CavaLMA LMA Ascending AortaAscending AortaDescending AortaDe
5、scending AortaLAD Left MarginalBranch LAD Left MarginalBranch CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPSuperior Vena CavaAscending AortaDescending AortaLAD Left MarginalBranch LMA LCX Superior Vena CavaAscending AortaDescending AortaLAD Left MarginalBranch LMA LCX Pulmonar
6、y ArteryPulmonary Artery CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPSuperior Vena CavaSuperior Vena CavaDescending AortaDescending AortaPulmonary ArteryPulmonary ArteryLAD LCx LCx LMB LMB LAD LeftAtriumLeftAtrium CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT AP
7、PL TiPSuperior Vena CavaSuperior Vena CavaDescending AortaDescending AortaPulmonary ArteryPulmonary ArteryLAD LCx LCx LMB LMB LAD LeftAtriumLeftAtrium CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPDescending AortaLCx LMB LAD LeftAtriumDescending AortaLCx LMB LAD LeftAtriumRight
8、AtriumLeftVentricleLeftVentricleAscending AortaAscending AortaRightAtrium CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPRCA RCA Left VentricleLeft VentricleRight VentricleRight VentricleLeft AtriumLeft AtriumRightAtriumRightAtriumLCx LMB LCx LMB CT平扫图象平扫图象 CT增强图象增强图象Cardiac Ana
9、tomyCardiac AnatomyGEMSC CT APPL TiPRCA Left VentricleRight VentricleLeft AtriumRightAtriumLCx LMB RCA Left VentricleRight VentricleLeft AtriumRightAtriumLCx LMB Descending AortaDescending Aorta CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPRCA RCA Left VentricleLeft VentricleR
10、ight VentricleRight VentricleLeft AtriumLeft AtriumRight AtriumRight AtriumLCx LMB LCx Cardiac Vein LMB Cardiac Vein CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPRCA Left VentricleRight VentricleLeft AtriumRight AtriumLCx LMB RCA Left VentricleRight VentricleLeft AtriumRight A
11、triumLCx LMB Aortic ValveDescending AortaDescending Aorta CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPRCA Left VentricleRight VentricleLeft AtriumRight AtriumLCx LMB RCA Left VentricleRight VentricleLeft AtriumRight AtriumLCx LMB Aortic ValveCardiac Vein Cardiac Vein CT平扫图象平扫
12、图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPRCA Left VentricleRight VentricleLeft AtriumRight AtriumLCx LMB RCA Left VentricleRight VentricleLeft AtriumRight AtriumLMB Descending AortaDescending Aorta CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPConus BranchCon
13、us BranchMitral ValveRCA Left VentricleRight VentricleLeft AtriumRight AtriumLMB RCA Left VentricleRight VentricleLeft AtriumRight AtriumLMB Cardiac Vein Cardiac Vein CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPRCA Left VentricleRight VentricleLeft AtriumRight AtriumLMB RCA R
14、ight VentricleLeft AtriumRight AtriumLeft VentricleMitral ValveDescending AortaDescending AortaCardiac Vein Cardiac Vein CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPRCA Left VentricleRight VentricleLeft AtriumRight AtriumRCA Left VentricleRight VentricleLeft AtriumRight Atriu
15、mDescending AortaDescending Aorta CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPDescending AortaDescending AortaRCA Left VentricleRight VentricleRight AtriumRCA Left VentricleRight VentricleRight AtriumCoronary Sinus Coronary Sinus CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac An
16、atomyGEMSC CT APPL TiPRCA Left VentricleRight VentricleRight AtriumRCA Left VentricleRight VentricleRight AtriumDescending AortaDescending AortaCoronary Sinus Coronary Sinus CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPRCA Left VentricleRight VentricleRight AtriumRCA Left Vent
17、ricleRight VentricleRight AtriumDescending AortaDescending Aorta CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPRCA Left VentricleRight VentricleRCA Left VentricleRight VentricleDescending AortaDescending Aorta CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiP
18、RCA Left VentricleRight VentricleRCA Left VentricleRight VentricleDescending AortaDescending Aorta CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPRCA Left VentricleRight VentricleRCA Left VentricleRight VentricleDescending AortaDescending AortaLiver Stomach Liver Stomach CT平扫图象平
19、扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPRCA Left VentricleRight VentricleRCA Left VentricleRight VentricleDescending AortaDescending Aorta CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPRCA Left VentricleRight VentricleRCA Left VentricleRight VentricleDescen
20、ding AortaDescending AortaLiver Stomach Liver Stomach CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPPDA Left VentricleRight VentriclePDA Right VentricleLiver Stomach Liver Stomach CT平扫图象平扫图象 CT增强图象增强图象Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiP房间隔缺损房间隔缺损Atrial Septal Defect
21、,ASDCardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPCT表现表现房间隔连续性中断。需两个层面以上可显示房;可直接测量缺损大小 右心房、室增大 肺动脉增宽 伴肺动脉高压,主肺动脉横径超过同水平主动脉,右心室壁增厚,右室扩大 Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiP继发孔型房间隔缺损继发孔型房间隔缺损CT增强:房间隔连续中断 Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiP室间隔缺损室间隔缺损Ventrical Septal Defect,VSD C
22、ardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPCT表现nEBCT薄层扫描,显示室间隔中断、不连续 n心室不同程度增大,肺血管增多、增粗 n血流序列扫描,观察分流,定量计算 Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiP室室间间隔隔缺缺损损(圆圆锥锥部部)GEMSC CT APPL TiP室间隔缺损(肌部)室间隔缺损(肌部)室间隔缺损(肌部)室间隔缺损(肌部)室间隔缺损室间隔缺损(膜周部)(膜周部)Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiP动脉导管未闭
23、动脉导管未闭 Patent Ductus Arteriosus,PDA Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPCT 表现表现nEBCT或螺旋CT增强扫描可显示PDA n较大的动脉导管,可见左心室增大 n肺动脉高压时,主肺动脉、左右肺动脉增宽,右心室增大 Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiP降主动脉呈一大漏斗状,导管与主肺动脉相连通Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPCT n瓣膜增厚,开放受限 n主肺动脉干狭窄后扩张 n左肺动脉右肺动脉 Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiP肺动脉瓣狭窄肺动脉瓣下狭窄 Cardiac AnatomyCardiac AnatomyGEMSC CT APPL TiPCardiac AnatomyCardiac Anatomy