DSCT数字化血管成像对冠状动脉搭桥术后桥血管的评价

目的：探讨DSCT数字化血管成像对冠状动脉搭桥术后随访应用价值。方法：采用西门子DSCT（Siemens SOMATOM Definition）对16例行冠状动脉搭桥术后患者行DSCT冠状动脉检查，分别评价CT图像桥血管近远端吻合口、桥血管本身有无狭窄、钙化和吻合口远端引流血管的图像质量及冠状动脉图像质量，评价双源CT诊断桥血管通畅性和冠状动脉是否存在狭窄。结果：DSCT显示16例患者共发现桥血管42根，其中6根闭塞，所有桥血管均可评价。42支桥血管中，25支未见狭窄，9支桥血管狭窄程度≤50％，8支桥血管狭窄程度〉50％。搭桥血管通畅率为85．7％（36／42），乳内动脉桥通畅率较高，为88．9％（8／9），肱动脉次之，为85．7％（6／7），大隐静脉桥通畅率最低，为76．9％（20／26）。结论：DSCT数字化血管成像作为一种无创性检查在冠状动脉桥血管随访的诊断和评价中是安全可靠的。

The Evaluation of the Graft Vessels after Coronary Artery Bypasses Graft with the Distal Angiography of DSCT

Objective： To evaluate the performance of Dual Source CT （DSCT） in the follow up of coronarvartery bypass grafts. Methods：16 patients with coronary bypass grafts underwent the DSCT coronary angiography（CTA） in Siemens SOMATOM Definition. The proximal and distal anastomosis, the bypass graft itself, and the run-off vessel detected in CTA images were evaluated for every coronary bypass graft, and the native coronary artery segments were evaluated too. The reliability of the DSCT detecting stenoses of the bypass grafts and the native coronary segments would be evaluated. Results： There were 42 bypass grafts in 16 patients with coronary bypass grafts underwent the DSCT coronary angiography（CTA） ,6 bypass grafts of the cases were blocked. All 42 bypass grafts were assessable. Twenty-five bypass grafts of the cases were flowing freely. Nine bypass grafts with insignificant stenosis（≤50%） and 8 bypass grafts with significant stenosis could be dearly displayed（〉50%）. 36 of 42 coronary bypass grafts including IMA patency in 88.9 （8 / 9）, RA in 85.7（6/7） and SVG in 76.9 （20 / 26） were patient. The overall patient rate was 85.7%. Conclusion： Noninvasive evaluating the bypass grafts with DSCT has great potential value in the follow-up.