心房颤动患者64层CT冠脉成像的扫描方法及后处理技术探讨

目的探讨心房颤动(房颤)患者64层螺旋CT冠状动脉成像的扫描方法及后处理技术的应用价值。方法所有31例房颤心律患者均进行64层螺旋CT扫描并采用绝对值时间法重组心脏容积数据,对其中12例患者心电信号进行编辑,再结合回顾性心电门控技术和后处理工作站进行冠状动脉成像。分析31例心房纤颤患者的冠状动脉CT血管成像(CTA)图像质量,利用血管分析软件判断血管有无狭窄并测量狭窄程度,其中10例患者的冠状动脉CTA结果与冠状动脉导管造影(CAG)进行了对照分析。结果 31例患者中364段血管节段成像质量分析结果:质量优、良、中和差分别为194段(53.3%)、82段(22.5%)、41段(11.3%)和47段(12.9%);成像质量优良率为276段(75.8%)。10例与CAG进行对照,共分析冠状动脉血管125段,CTA诊断血管狭窄程度≥50%的敏感度为85.0%(17/20),特异度为95.2%(100/105)。结论 64层螺旋CT能够对房颤患者进行冠状动脉CTA检查,结合心电编辑、回顾性心电门控和工作站后处理技术,可以重建出较高质量的冠状动脉图像。

Coronary artery imaging with 64-slice CT in atrial fibrillation patients: Scanning Method and Post-processing techniques

Objective To discuss the clinical value of coronary artery imaging using 64-slice CT in patient with atrial fibrillation. Methods All the cardiac volume data of 31 patients with atrial fibrillation were reconstructed using absolute time method. The images of 12 patients The images of 31 patients who underwent contrast-enhanced CT coronary angiography were evaluated. The presence of stenosis on each segment of coronary arteries was recorded and their degree of stenosis was measured using the vessel analysis software. The results of conventional coronary angiography （CAG） of the 10 patients were compared with CT coronary angiography. Results The image quality of 364 coronary vessel segments on the images from 31 patients was evaluated and defined as excellent, fine, moderate or poor. The image quality was excellent, fine, moderate and poor in 194（53.3%）, 82（22.5%）, 41（11.3%） and 47（12.9%） vessel segments. Comparison was carried out between CTA findings and CAG findings of the 125 segments of the coronary arteries in the 10 patients who underwent CAG. The sensitivity and specificity of CTA for diagnosing vessel with stenosis （〉150% narrowing） was 85%（17/20） and 95.2% （100/105）. Conclusion Coronary artery imaging using 64-slice CT is useful in patient with atrial fibrillation.