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to the family members of patients and hospital adds a lot of pressure, congenital heart disease more common for ventricular and atrial septal defect, patent ductus arteriosus, pulmonary artery valve, aortic stenosis and tetralogy of Fallot, transposition of great vessels and so on. Most children born physical examination because of a heart murmur, some bruising, difficulty breathing and other symptoms and early diagnosis. Approximately 1/3 to 1/2 in children with congenital heart disease died within a year after birth due to severe heart malformations [2]. Survivors recurrent respiratory tract infections in various age stages of their growth and development, developmental disorders. Early mild cases also may be asymptomatic, but the presence of precordial murmur will affect children for further studies and employment if not treated, will eventually lead to pulmonary hypertension, heart enlargement, heart failure, and some endocarditis, embolism bleeding, high blood pressure, and so on. Congenital heart disease in China, accounting for newborns 0.7% to 0.8%, more than 40,000 patients annually congenital heart surgery, and more 1/5 for the complex congenital heart disease, and in recent years, through continuous scientific and technological research, treatment of complex congenital heart has been a great development, but the complexity of heart disease is still the heart of the difficulty of treatment outside the most important reason is the preoperative diagnosis is difficult, there is no accurate lesion data, the lack of a full assessment of the surgery, complex congenital heart disease too complex anatomical relationship of the heart and great vessels, may lead to different situations, need to take unreasonable surgery, preoperative evaluation of the space anatomical relationship of the lesions, and the severity of the lesions, whether the establishment of collateral vessels vital data on the clinical treatment With the rapid development of medical imaging equipment, a variety of examination methods in technology has made great development, greatly contributed to raising the level of congenital heart disease diagnosis, examination of congenital heart disease in the past mainly rely on ultrasound echocardiography (UCG) inspection methods such as magnetic resonance imaging (MRI) and angiocardiography, in recent years, multidetector CT 64-slice CT into clinical applications, CT CHD diagnosis more widely applied to precisely display of complex congenital heart space anatomical relationship, and quantitative measurement of lesions. The study by 64-slice CT examination of complex congenital heart surgery results were compared to study the 64-slice CT for the diagnosis of complex congenital heart value and angiocardiography (ACG), the previous most diagnostic value of echocardiography diagram ( UCG) conducted a comparative analysis of the statistics of the variety of checking the accuracy of the method and the specific differences, in order to find the optimal choice of a variety of inspection methods. Methods: We collected our hospital 65 cases confirmed by surgery, complex congenital heart line Cardiovascular Angiography (ACG) in all cases preoperative echocardiography the Figure (UCG) and magnetic resonance imaging (MRI), all lesions are classified analysis the sensitivity and specificity of the lesion, the various inspection methods for statistical analysis. Various inspection methods to check the following manner: 64-slice CT cardiovascular angiography: cubital vein or jugular vein injection of contrast medium, iodine concentration of 370mg iodine / ml of non-ionic contrast agent iopamidol, using binoculars high pressure syringe Bolus injection of contrast agent, the contrast agent Ann 1.5ml/Kg calculated, injection speed from 0.5ml / s ~ 3.0 ml / s, in accordance with the actual situation of the patient, individualized calculation to determine the injection speed the trocar 22 ~~ 24G, enhanced scan using bolus tracking (bolus tracking) triggered scanning technology, control technology plus ECG, blood vessel tracking for the right room at the entrance of the superior vena cava, delay 8s start scanning, scan parameters: 120mAs, 100KV, scanning, range from the apex to subphrenic 5cm, pitch 0.3, rotation speed of the tube: 0.33s / week, faults collimator combinations 64X0.6mm, the reconstruction thickness 0.75mm, 16ml saline pre-injection shot before the injection of the contrast agent, in order to understand blood vessels through the situation, to avoid leakage of the contrast agent, after their injection of contrast medium in the contrast agent injection 20 ~ 30ml, to speed up the circulation of the contrast agent to reduce residual contrast agent in the superior vena cava, avoid the high concentration of the contrast agent in the superior vena cava caused radioactive artifacts affect pulmonary adjacent structure display. Image processing method: the original image of all patients curved reconstruction (CPR), multi-planar reconstruction (MPR), thin greatest objective projection (MIP-thin) and volume rendering technology (VRT) method for the reconstruction process, the integrated use various post-processing method, demonstrated lesions, and using a measurement tool for accurate measurement of the lesions. Echocardiography: the standard left lateral position supine peace, if necessary, using unconventional postural take a left ventricular long section, apical four-chamber, five-chamber heart, sword under the five-chamber section detection. First, using two-dimensional sonographic the heart internal and external structural analysis, and then show heart blood flow signals inside and outside of each section to the CDE site shunt beam width, phase, color to determine abnormal shunt site, sub-flow and shunt direction. Multi-angle scanning infer the anatomical relationship of the atrioventricular and the main artery of the space, and the measurement of left and right pulmonary artery and thoracic aorta through the diaphragm at the level of aorta. The cardiovascular angiography X-ray: the patient's anesthesia using ketamine intravenous anesthesia local anesthesia plus lidocaine puncture site, the contrast agent using non-ionic 370mg iodine / ml contrast agent Ultravist or iohexol alcohol and other 1:8 dilution cardiac catheterization order by the left or the right femoral artery and femoral vein catheterization, right heart catheterization, reached on the inferior vena cava, right atrium, left ventricle, pulmonary artery, pulmonary arterioles (small pulmonary vein) atrial septal defect atrial septal defect to the left atrium; left ventricular catheter retrograde through the descending aorta, the ascending aorta to the left ventricle. Line pressure and oxygen saturation monitoring. The angiocardiography underwent selective left and right ventricular and aortic angiography necessary line of small pulmonary artery wedge angiography to understand the changes of the pulmonary vascular bed [3]. MRI: MRI uses a high-end GE 3.0T MR equipment, scan the first sweep of the standard plane positioning like scanning above the plane including the aortic arch, to subphrenic below 3cm All patients underwent unenhanced coronal scan, research and evaluation heart, aortic arch, pulmonary artery, pulmonary vein, valves, and inferior vena cava and visceral film scanning also includes the major axis plane left ventricular long axis horizontal and vertical planes, measurement or functional analysis of the heart, in all cases but also dynamic enhanced scan angiography for blood flow path, showing the phases of the blood vessels, used to analyze heart macrovascular whether abnormal scan range needs to include the large blood vessels of the heart and chest. Results: this group of patients after surgery confirmed heart malformations and lesions of 285, 274 found lesions in CT angiography, the diagnosis rate of 96.5%, echocardiography Figure (UCG) to check out the lesion 238 diagnostic rate of 83.7% , X line cardiovascular angiography confirmed 213, the diagnosis rate of 79.4%; cardiac vascular lesions of 132, 131 CT cardiac imaging, diagnostic rate of 99.7, a result of image motion artifacts, resulting in lesions missed , echocardiography showed 96, the diagnosis rate of 74.3%, The X light angiocardiography shows 125, the diagnosis rate of 93.4%; opening variation, discovered lesions six cases, for coronary CT angiography lesion was found six cases, diagnostic rate of 100%, echocardiography Figure (UCG) to check out the lesion 0 diagnostic coincidence rate 0%, 2 the X lines cardiovascular angiography confirmed, the diagnosis rate of 33.3%; measurement of pulmonary artery diameter, CT angiocardiography error of 5% of the measured value and the actual width echocardiography Figure measured value and the actual width of the error of 24%, the contrast measured value and the actual value of the X-line cardiovascular error of about 16% above statistical data analysis, see CT heart angiography, intracardiac malformations show the variability of the great vessels, pulmonary measurement with color Doppler ultrasound, X-ray cardiovascular imaging compared with the obvious advantages, especially for the display opening variability and coronary lesion inspection was significantly higher than the other methods, X line for Cardiovascular Angiography of variation have openings for the display of the heart and great vessels and coronary better check rates, the gold standard used to be called a cardiovascular check, but in this trial, CT angiocardiography were significantly lower than its inspection rate and the measured value of the lesion and the actual error. Conclusion: The in cardiovascular examination three means: echocardiography heart diagram, the X lines cardiovascular angiography, CT angiocardiography cardiac abnormalities have a higher detection rate can be used as the evaluation of cardiac malformations technical means for heart valve morphology and movement indeed loss of triage situation, the movement of the myocardium, ultrasound has some advantages, but for ectopic drainage of the pulmonary artery, vein, aortic lesions, coronary conditions and collateral circulation, CT cardiovascular imaging was significantly superior to other tests, a statistically significant difference (P lt; cell mouse embryos to ethanol was around 1.5), in particular, is a variation of the show opening in the coronary 64CT check for Cardiovascular Angiography of coronary lesions was 100 %, the preferred method of examination should be opening as coronary variability, X-ray as a traditional gold standard for the diagnosis of cardiovascular disease, but the ways invasive examination, the surgical risk, and overlapping images before and after, can not multi-angle display the inspection methods have been gradually ultrasound and CT replaced only advantage is the measurement of pulmonary artery pressure, echocardiography visible to solve most of the diagnosis of congenital heart disease, but due to the image of the acoustic window and bone artifacts, for approaching lesions of bone and lung tissue is unclear, there is a certain misdiagnosis may, 64-slice CT examination with high accuracy, low cost, safe, noninvasive as congenital heart disease check first checks.
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