320排容积CT在冠状动脉搭桥术后桥血管成像中的应用

目的：评价320排容积CT对冠状动脉搭桥术后桥血管成像的应用价值。方法：55例搭桥术后患者（男36例），共计126条桥血管，其中52条动脉桥，61条静脉桥，13条序贯桥血管。所有患者在术后3~9个月进行320排容积CT桥血管成像检查，对所有病例图像进行后处理重建，包括多平面重组（MPR）、曲面重组（CPR）以及容积再现（VR）等。由2位有经验的放射科医生对重建图像进行观察，对桥血管成像质量进行评估（优、良、差），并对桥血管的通畅性（通畅、轻度狭窄、中度狭窄、重度狭窄）进行初步评价。结果：55例患者均顺利完成冠状动脉桥血管320排容积CT成像检查，在待评价的126条桥血管中，116条桥血管显影，其中图像质量优97条（83.6％）、良19条（16.4％），差0条（0％），10条桥血管未见显影考虑闭塞。此外，发现8条动脉桥血管管壁存在钙化，5条动脉桥血管、5条静脉桥以及2条序贯桥血管可见近端或远端吻合口不同程度狭窄。结论：320排容积CT能够清晰显示冠状动脉桥血管，并且能够对桥血管及吻合口狭窄情况进行评估，是一种良好的无创性冠状动脉桥血管成像方法。

The application of 320-row volume CT scan in coronary artery bypass grafts imaging

Objective：To investigate the application of 320-row volume CT scan in coronary artery bypass grafts（CABG） imaging.Method：Fifty-five cases（male 36） after 3～9 months of the operation of CABG were enrolled in this study and underwent coronary artery graft imaging using 320-row volume CT scan.Total 126 grafts（52 arterial grafts,61 venous grafts and 13 sequential grafts） were evaluated.Grafts images were reconstructed using multiple planar reformations（MPR）,curved planar reformations（CPR） and volume rendering（VR）.The image quality（good,moderate and poor） and stenosis of grafts（non-stenosis,slight,mild and severe stenosis） were evaluated.Result：All the 55 patients（126 grafts） accepted 320-row volume CT scan after CABG operation.116 grafts were filled with contrast agent and the other 10 grafts which no contrast agent in lumen were considered as total occlusions.The image quality of 116 grafts was good（97 grafts,83.6%） or moderate（19 grafts,16.4%）.No poor image quality was observed.Calcifications of wall were found in 8 grafts.Lumen stenosis was found in 5 arterial grafts,5 venous grafts and 2 sequential grafts.Conclusion：320-row volume CT scan can image grafts clearly and can be used to evaluate stenosis of graft.It is a good noninvasive method for graft imaging after CABG operation.