多排螺旋CT冠状动脉造影检查的护理体会

目的:探讨多排螺旋CT冠状动脉造影检查的护理体会分析。方法:选取的100例研究对象是我院进行多层螺旋CT冠状动脉造影患者,选取的时间段为2018年10月至2019年8月。所有患者均接受接受优质护理,对比护理前后的CT图像质量以及患者的心理变化。结果:接受护理后,患者的CT图像质量较好,焦虑情况得到有效改善,差异具有统计学意义(P<0.05)。结论:给予行多层螺旋CT冠状动脉造影检查患者优质护理,有效改善患者焦虑情绪,配合接受检查,能够有效提高CT图像质量,提高检查成功率。     

64排螺旋CT冠状动脉造影的护理

目的 评价在64排螺旋CT冠状动脉造影检查中相关护理的重要性.方法 对850例行64排螺旋CT冠状动脉造影检查患者进行严格的护理操作和指导,并对相关图像资料进行回顾性分析.结果 850例64排CT冠脉检查患者无一例渗漏,成功率(图像优良)达到95.63%.结论 严格的护理操作和心理、生理干预是64排螺旋CT冠脉造影检查成功的重要保证.     

64排螺旋CT冠状动脉造影的护理

目的评价在6 4排螺旋CT冠状动脉造影检查中相关护理的重要性。方法对8 5 0例行6 4排螺旋CT冠状动脉造影检查患者进行严格的护理操作和指导,并对相关图像资料进行回顾性分析。结果8 5 0例6 4排CT冠脉检查患者无一例渗漏,成功率(图像优良)达到9 5.6 3%。结论严格的护理操作和心理、生理干预是6 4排螺旋CT冠脉造影检查成功的重要保证。     

64排螺旋CT行冠状动脉造影检查围手术期护理

64排螺旋CT是目前世界上诊断心脑血管疾病先进的仪器,其独具的无创、高效、精确和立体的医学影像技术,在检查状动脉有无狭窄,搭桥、支架的形态学以及心功能分析上有极大的优越性。它实现了冠状动脉的无创检查,为冠心病的筛选普查及诊断提供了一种安全、     

影响64排CT冠状动脉造影非技术因素及护理

对106例行64排CT冠状动脉造影的患者给予有针对性的护理,结果除1例在造影剂推注过程中造影剂外渗,2例因呼吸影响重做,其余患者均获得满意的检查结果,达到诊断目的.认为针对检查非技术因素的护理干预贯穿检查的全程,可使患者在检查相应环节上予以积极配合,有助于检查的顺利进行,提高检查成功率.     

64排螺旋CT冠状动脉造影的护理配合

目的探讨护理配合在64排螺旋CT冠状动脉造影检查中的重要性。方法对281例患者行64排螺旋CT冠状动脉造影检查,进行严格的护理操作和耐心、细致的心理疏导,分析护理配合对冠脉成像图像质量的影响。结果 281例64排CT冠脉检查患者无1例渗漏,94.7%患者影像质量确认为优良,能够满足影像学诊断要求;5.3%患者扫描期间心率突然上升至70次/min以上,影像质量不能满足影像学诊断要求。结论严格的护理操作和耐心、细致的心理疏导是保证64排螺旋CT冠脉造影检查成功的关键。     

影响64排CT冠状动脉造影非技术因素及护理

对106例行64排CT冠状动脉造影的患者给予有针对性的护理，结果除1例在造影剂推注过程中造影剂外渗，2例因呼吸影响重做，其余患者均获得满意的检查结果，达到诊断目的。认为针对检查非技术因素的护理干预贯穿检查的全程，可使患者在检查相应环节上予以积极配合，有助于检查的顺利进行，提高检查成功率。     

64排螺旋CT冠状动脉造影检查病人的护理

目前,心血管疾病已成为威胁人类健康与生命的第一杀手,冠状动脉造影是诊断的金标准[1], 但导管法是有创性检查,检查费用高,具有一定的危险性.64排螺旋CT冠状动脉造影扫描速度快、信息量大,具有惊人的图像锐利度和清晰度,病人安全、痛苦小,且病人与医护人员接受X线辐射少,在临床工作中得到广泛应用.本文就与该项检查有关的护理问题进行探讨,提出相应的护理对策.     

64排螺旋CT冠状动脉血管造影的护理现状

阐述64排螺旋CT冠状动脉血管造影临床护理的应用现状,旨在为进一步提高冠状动脉血管造影术的临床效果、推广64排螺旋CT的临床应用、有效改善护患关系、促进患者对护理质量的满意度等方面奠定理论基础。     

64排螺旋CT冠状动脉血管造影的护理

目的 明确护理对64排螺旋CT冠状动脉造影检查的重要性.方法 记录194例患者冠状动脉造影时的护理过程与总结经验.结果 194例患者中有5例患者因未能屏住气需重做,经重新训练后检查,获得较佳图像.有5例患者出现不同程度过敏,经及时处理症状得到缓解.结论 利用64排螺旋CT进行冠状动脉血管造影检查对临床应用有着十分重要的意义,作为护理人员要十分了解该项检查技术的重要特点和临床应用价值,对配合医技人员做好护理工作具有极其重要意义.     

320排容积CT检查对冠脉支架植入术后患者支架内再狭窄的评价

目的 探讨320排容积CT对冠脉内支架植入术后忠者支架内再狄窄的评估价值.方法 对81例冠心病经皮冠脉介入治疗术后患者的临床资料进行观察分析,以冠脉造影结果为金标准,计算320排容积CT对诊断支架内再狭窄的灵敏度、特异度、阳性预测值、阴性预测值.结果 320排容积CT对支架内再狭窄诊断的灵敏度、特异度、阳性预测值、阴性预测值分别为94.87%、98.1%、92.5%、98.73%.结论 320排容积CT对支架内再狭窄的诊断有较高的阳性预测值,可以用于冠状动脉支架植入术后对冠脉支架的随访.     

64排螺旋CT血管成像评估内瘘血管的价值

目的 探讨64排螺旋CT血管成像(computed tomographic angiograhpy,CTA)评估血液透析患者动静脉内瘘血管的临床价值.方法 应用64排CTA对14例功能不全的内瘘血管及临床评估自体血管无条件造瘘的患者进行扫描、采象,应用最大密度投影、容积成象和曲面重建技术对图象数据进行处理和3维重建.结...     

多层螺旋CT诊断冠状动脉-肺动脉瘘1例

患者，男，55岁，半年前无明显诱因出现胸闷，活动后加重。心电图：前壁、侧壁ST-T改变，aVL病理性q波，左室高电压，窦性心律，心脏顺时针转位。行冠状动脉MSCTA检查，在心电门控下，以4.0ml／s的流速小剂量测试（test bolus）测得循环时间，根据循环时间设定延迟时间24s，     

Initial evaluation of coronary images from 320-detector row computed tomography

Purpose To evaluate image quality and contrast opacification from coronary images acquired from 320-detector row computed tomography (CT). Patient dose is estimated for prospective and retrospective ECG-gating; initial correlation between 320-slice CT and coronary catheterization is illustrated. Methods Retrospective image evaluation from forty consecutive patients included subjective assessment of image quality and contrast opacification (80 ml iopamidol 370 mg I/ml followed by 40 ml saline). Region of interest opacification measurements at the ostium and at 2.5 mm diameter were used to determine the gradient of contrast opacification (defined as the proximal minus distal HU measurements) in coronary arteries imaged in a single heartbeat. Estimated effective dose was compared for prospective versus retrospective ECG-gating, two body mass index categories (30 kg/m² cutoff), and single versus two heartbeat acquisition. When available, CT findings were correlated with those from coronary catheterization. Results Over 89% of arterial segments (15 segment model) had excellent image quality. The most common reason for image degradation was cardiac motion. One segment in one patient was considered unevaluable. Contrast opacification was almost universally considered excellent. The mean Hounsfield units (HU) was greater than 350; the coronary contrast opacification gradient was 30–50 HU. Patient doses were greater for retrospective ECG-gating, larger patients, and those imaged with two heartbeats. For the most common (n = 25) protocol (120 kV, 400 mA, prospective ECG-gating, 60–100% phase window, 16 cm craniocaudal coverage, single heartbeat), the mean dose was 6.8 ± 1.4 mSv. All CT findings were confirmed in the four patients who underwent coronary catheterization. Conclusion Initial 320-detector row coronary CT images have consistently excellent quality and iodinated contrast opacification. These patients were scanned with conservative protocols with respect to iodine load, prospective ECG-gating phase window, and craniocaudal coverage. Future work will focus on lowering contrast and radiation dose while maintaining image quality.     

心理健康指导对320排动态容积CT冠状动脉检查病人心率及成像质量的影响

[目的]探讨心理健康指导对320排动态容积CT冠状动脉检查病人心率及成像质量的影响。[方法]将200例行320排动态容积CT冠状动脉造影检查的病人随机分为心理指导组100例和常规组100例,心理指导组在检查全过程中主要采用语言沟通和护理行为干预,常规组按常规护理操作进行,比较两组病人紧张、焦虑程度,检查前和扫描过程中的心率及波动范围对冠状动脉图像质量的影响。[结果]两组病人在检查前的情绪和检查过程中的心率稳定情况及冠状动脉血管成像质量和图像有无运动性伪影等方面均有统计学意义(P<0.05);病人接受的射线量与心率的快慢有关。[结论]320排动态容积CT冠状动脉造影中进行全程心理健康指导能有效减轻病人的焦虑、恐惧心理,减少扫描时的心率波动,可减少射线量和稳定心率,提高冠状动脉成像质量。     

Coronary artery fistula in a patient with coronary artery disease: evaluation by coronary angiography and multidetector computed tomography

A 54-year-old man with acute miyocardial infarction was successfully treated with coronary artery stenting. Coronary angiography is the preferred diagnostic method for imaging the coronary arteries, but coronary artery fistulas origin and course may not be apparent. New tomographic cardiovascular imaging tests such as, multidetector computed tomography (MDCT) can be used to precise delineation of coronary fistulas. An erratum to this article can be found at     

64排CT冠状动脉成像诊断冠状动脉狭窄的临床价值

目的 评价64排CT冠状动脉成像(CTCA)技术诊断冠状动脉显著狭窄(≥50%管腔狭窄)的临床价值.方法 采用CTCA对61例临床疑诊冠心病患者进行检查,并于CTCA检查后2周内行选择性冠状动脉造影(SCA).结果 1例患者因冠状动脉严重钙化4支血管CTCA不可评估,其余60例患者240支冠状动脉血管CTCA均可良好显影,240支血管显著狭窄诊断的灵敏度、特异度、阳性预测值及阴性预测值分别为90.0%(72/80)、91.9%(147/160)、84.7%(72/85)、94.8%(147/155).结论 CTCA显示了较高的阴性预测值,可以作为排除冠状动脉显著病变的一种无创标准性检查.     

320排CT血管成像对冠状动脉瘘的诊断价值

目的探讨320排CT血管成像对冠状动脉瘘的诊断价值。方法回顾性分析34例冠状动脉瘘患者的320排CT血管成像资料及临床资料,其中11例患者同时进行冠状动脉造影检查。结果 26 590例患者中共34例诊断为冠状动脉瘘,发病率为0.13%。34例冠状动脉瘘中冠状动脉-肺动脉瘘26例(76.5%),冠状动脉-左心室瘘3例(8.8%),冠状动脉-右心房瘘3例(8.8%),冠状动脉-左心房瘘1例(2.9%),冠状动脉-右心室瘘1例(2.9%)。起源于左冠状动脉8例(23.5%),起源于右冠状动脉10例(29.4%),同时起源于两侧冠状动脉者16例(47.1%)。16例(47.1%)伴随瘤样扩张。瘘口直径范围2.0~13.0 mm,中位直径2.5 mm。瘘口两端见浓染征15例(44.1%),射血征10例(29.4%),等密度征9例(26.5%)。11例均经冠状动脉造影证实为冠状动脉瘘。结论冠状动脉瘘发病率低,其中冠状动脉-肺动脉瘘是最常见的类型(占76.5%),同时起源于两侧冠状动脉占47.1%。320排CT血管成像能无创、准确地显示冠状动脉瘘的起源、瘘血管走行、瘘口直径及引流部位,可作为诊断冠状动脉瘘的首选检查方法。     

320排容积CT在冠状动脉搭桥术后桥血管成像中的应用

目的：评价320排容积CT对冠状动脉搭桥术后桥血管成像的应用价值。方法：55例搭桥术后患者（男36例）,共计126条桥血管,其中52条动脉桥,61条静脉桥,13条序贯桥血管。所有患者在术后3~9个月进行320排容积CT桥血管成像检查,对所有病例图像进行后处理重建,包括多平面重组（MPR）、曲面重组（CPR）以及容积再现（VR）等。由2位有经验的放射科医生对重建图像进行观察,对桥血管成像质量进行评估（优、良、差）,并对桥血管的通畅性（通畅、轻度狭窄、中度狭窄、重度狭窄）进行初步评价。结果：55例患者均顺利完成冠状动脉桥血管320排容积CT成像检查,在待评价的126条桥血管中,116条桥血管显影,其中图像质量优97条（83.6％）、良19条（16.4％）,差0条（0％）,10条桥血管未见显影考虑闭塞。此外,发现8条动脉桥血管管壁存在钙化,5条动脉桥血管、5条静脉桥以及2条序贯桥血管可见近端或远端吻合口不同程度狭窄。结论：320排容积CT能够清晰显示冠状动脉桥血管,并且能够对桥血管及吻合口狭窄情况进行评估,是一种良好的无创性冠状动脉桥血管成像方法。     

Narrowing the phase window width in prospectively ECG-gated single heart beat 320-detector row coronary CT angiography

Purpose To evaluate the relationship between the phase window width and image quality in prospectively ECG-gated 320-detector row coronary CTA, and to evaluate the relationship between heart rate and the number of cardiac phases with diagnostic quality images. Methods Thirty-six phases (60–95% R-R, 1% increments) were reconstructed in 41 consecutive prospectively gated single R-R 320 × 0.5 mm detector row coronary CTA patients. For each phase, two cardiovascular imagers retrospectively documented the phases considered diagnostic for the left anterior descending (LAD), left circumflex (LCx), and right coronary artery (RCA). The smallest phase window width including at least one diagnostic phase for 95% of coronary arteries was determined, and after accounting for sampling variation, the same smallest window width was estimated for the general population. Inter-rater agreement was determined. A linear regression model evaluated the relationship between heart rate and width of diagnostic phase windows. Results Widening the phase window width increases the proportion of coronary arteries with at least one diagnostic phase. Among the 41 patients, 95% of vessels had a diagnostic phase in the 72–77% phase window. Accounting for sampling variation, the 72–81% phase window has a 0.95 probability of including a diagnostic phase for 95% of coronary arteries in the general population. Interobserver agreement was 0.959 with 0.95 confidence interval [0.908, 0.987]. Patients with a lower heart rate had significantly more diagnostic phases. Conclusions For prospectively ECG-gated single heart beat coronary CTA, a phase window width of 10% will reduce patient radiation and yield diagnostic images in >90% of patients. Heart rate control is an important component of 320-detector row prospectively gated CT dose reduction.