电子束计算机断层血管造影及三维重建在冠状动脉搭桥术后的临床应用

目的探讨电子束计算机断层（ＥＢＣＴ）血管造影及三维重建在冠状动脉搭桥术后的临床应用价值。方法均采用单层增强扫描（ＳＳＭ）和血流扫描（ＦＬＯＷＳＴＵＤＹ）；三维重建采用表面阴影显示法（ＳＳＤ），并与手术结果做了对照，其中７例有术后造影检查结果。结果１５０例ＥＢＣＴ扫描及三维重建均获得成功；３９９支搭桥血管中有３１８支显示通畅，通畅率为７９７％；其中，１００支乳内动脉桥中８７支通畅（占８７％），２９６支大隐静脉桥中２２８支通畅（占７７％），３支桡动脉桥全部通畅（１００％）。７例患者ＥＢＣＴ结果显示１２支桥有５支发生了阻塞，与其造影结果一致。结论ＥＢＣＴ是评价搭桥血管通畅与否的很有价值的无创方法，并有望取代常规心血管造影。

Three dimensional reconstruction of electron beam computed tomography angiography for evaluating coronary artery bypass graft patency

Objective To probe into the value of electron beam computed tomography (EBCT) for evaluating coronary artery bypass graft (CABG) patency follow up. Methods EBCT enhanced single slice mode (SSM) and flow study were performed in 150 patients. The results of 3 D reconstruction of CABG were correlated with bypass operation records and coronary arteriograms in 7 patients. Results 318 of 399 coronary bypass grafts including IMA in 87/100(87%) and SVG in 228/296(77%) were patent. The overall patent rate was 79.7%. In 7 patients with 12 coronary bypass grafts , EBCT studies showed graft patency in 7 and occlusion in 5, as were confirmed by conventional graft angiography.Conclusion EBCT angiography is a noninvasive method that could replace conventional coronary arteriography for CABG follow up.