统一体位在16排螺旋CT评价冠状动脉狭窄中的应用

目的通过建立统一的重组图像体位,研究16层螺旋CT(MSCT)诊断冠状动脉狭窄的准确性。方法对55例临床可疑冠心病患者16层MSCT心电门控增强扫描。用舒张期增强扫描图像行统一体位的最大密度投影(MIP)及容积显示(VR)重组,分析应用CT血管成像(CTA)7个MIP重组体位和9个VR重组体位评价冠状动脉狭窄≥50%的情况,将结果与常规X线冠状动脉造影作对照。结果共分析55例患者的220个血管分支,常规冠状动脉造影发现62个血管分支狭窄≥50%,综合7个MIP重组体位和9个VR重组体位,CTA发现58个血管分支狭窄≥50%(左主干5个,前降支21个,回旋支14个,右冠状动脉18个)。CTA诊断冠状动脉狭窄≥50%的敏感性为94%(58/62),特异性为92%(146/158)。结论 16层MSCT诊断冠状动脉狭窄有较高的敏感性和特异性;建立统一的成像体位有利于CTA与常规X线冠状动脉造影结果对照。

Application of multi-slice spiral CT with standardized reconstruction images in coronary artery stenosis

Objective To study the diagnostic accuracy of multi-slice spiral computed tomography （MSCT） with standardized reconstruction images for evaluating coronary artery stenosis. Methods Fifty-five patients with suspected coronary artery disease underwent ECG-gated 16-MSCT. The axial, MIP （7 patients） and VRT （9） reconstructed images were reviewed for coronary artery stenosis of 50% or more diameter reduction. The results were compared with those of conventional coronary angiography （CAG）. Different orientations of dis- playing the coronary arteries were evaluated. Results Significant disease was detected on CAG in 62/220 evaluable branches including left main, left anterior descending, left circumflex and right coronary arteries in 55 patients. On the 7 MIP and 9 VRT reconstruction images, 58/62 stenotic vessels （5 in the left main, 21 left anterior descending, 14 circumflex and 18 right coronary arteries） were correctly identified. Without excluding any branches, the sensitivity and specificity ofCT angiography （CTA） for detecting≥ 50%stenosis were 94% （58/62） and 92% （146/ 158）, respectively. Conclusion Improvement in 16-MSCT technology allows noninvasive detection of coronary artery stenosis with high accuracy. The establishment of CTA standard orientations is helpful for evaluation of coronary artery lesions in comparison with the conventional coronary angiography.