多层螺旋CT无创性冠状动脉造影图像质量分析及冠状动脉病变评价

目的分析多层螺旋CT无创性冠状动脉造影图像质量的主要影响因素，以正确评价冠状动脉病变。方法64例患者行多层螺旋CT冠状动脉造影检查，用回顾性心电门控选择最佳相位窗，并分别以容积再现（VR）、最大密度投影（MIP）、曲面重建（CPR）等后处理技术将冠状动脉分为15个节段进行分析。结果显示血管直径大于2mm的冠状动脉节段共960个，能满足影像学评价的节段共884个（92．08％）；不能满足影像学评价的节段共76个（7．92％）；64例中的58例（90．63％）冠状动脉CTA图像质量均为2级或1级，其余6例（9．37％）冠状动脉CTA图像质量为3级，共发现冠状动脉存在中、重度狭窄者44例（占68．75％），其中单支病变28例，双支病变16例；另发现冠状动脉存在轻度狭窄者16例（占25．00％），其中单支病变8例，双支病变8例；冠状动脉未见明确狭窄者4例（6．25％）。结论高质量的MSCT无创性冠状动脉造影对冠状动脉病变有较高的诊断价值。

Noninvasive coronary angiography using MSCT for the detection of coronary artery disease;a study of imaging quality and its influence factors

Objective To analyze the influence factors of imaging quality and to evaluate the diagnostic potency during noninvasive coronary angiography using muhislice spiral computerized tomography （MSCT） for detecting coronary artery disease （CAD）. Methods Sixty- four patients with clinically suspected or known CAD underwent the examinations of MSCT by using a retrospectively ECG-gating technique and optimal phase window. The coronary arteries in all patients were divided into 15 segments by using VR, MIP and CPR for performing the evaluation. Results In all 64 patients, MSCT showed that, a total of 960 coronary artery segments were more than 2.0 mm in diameter, of those, 884 （92.08%） were evaluable segments and 76（7.92%） were non-evaluable segments; the imaging quality of 58 patients （90.63%） achieved to second or first grade which was able to satisfy the diagnostic requirement, while that of remainder 6 patients （9.37%） were third grade which was unable to satisfy the diagnostic requirement; moderate to severe coronm＇y artery stenoses were found in 44 （68.75 %） patients（single and dual branch were 28 and 16, respectively）, mild coronary artery stenoses were found in 16（25.00%） patients（single and dual branch were 8 each）; non-obvious coronary artery stenoses were found in 4 （6.25%） patients. Conclusion High qualitative noninvasive coronary angiography using MSCT has great potency for diagnosing CAD.