16层螺旋CT冠状动脉成像的应用技术探讨

目的探讨16层螺旋CT冠状动脉成像的技术方法并对成像质量的影响因素进行分析.方法对47例临床怀疑冠心病患者和3例植入冠状动脉支架患者进行16层螺旋CT冠状动脉成像,采用心脏平扫和经肘静脉以3 ml/s的速率注入100 ml对比剂增强扫描,分别进行钙化积分分析和冠状动脉MPR、MIP、VRT三维重建,评价冠状动脉主干和各级分支的显示情况.结果在患者准备充分和扫描技术合理的情况下,螺旋CT冠状动脉成像对冠状动脉主干和主要分支的显示达到诊断要求.三维重建的图像质量受心脏和呼吸运动、回顾性门控技术选择、扫描参数的设置以及射线硬化效应的影响.结论螺旋CT冠状动脉成像对于冠状动脉疾病的诊断和术后复查具有很高的临床价值.在检查中充分准备和训练患者、选择合理的技术参数是获得高质量三维重建图像的重要因素.

Clinical application of spiral CT coronary angiography

Objective To evaluate the technique of 16-detector row CT coronary angiography in clinical application and analyze the influencing factors for image-forming qualities. Methods The 16-detector row CT coronary angiography was performed in 50 patients, including 47 cases of suspected coronary disease and 3 cases of coronary stent placement. All the cases respectively underwent calcium scores analysis and coronary artery MPR, MIP, VRT 3D reconstruction with heart plain scan and contrast-enhanced scan after injected 100 ml contrast medium at the rate of 3 ml/s into ulnar vein. The demonstration of main stem and all level branches of coronary artery were evaluated. Results Under the condition of patient full preparation and proper scan technique, the demonstrations of main stem and the most of branches of coronary artery reached the diagnostic requirement. The image quality of 3D reconstruction was influenced by heartbeats, breath, the selection of retrospectively ECG-gated, the set-up of scanning parameter and beam-hardening effects. Conclusion Spiral CT coronary angiography has high clinical value in diagnosis of coronary artery disease and postoperative check. The full preparation for physical examination, patient training, and proper selection of technique parameter are important factors to obtain qualified 3D reconstruction image.