40层螺旋CT冠状动脉造影的临床应用

目的 探讨40层螺旋CT诊断冠状动脉粥样硬化性心脏病(冠心病)的价值.方法 回顾性分析我院2005年10月～2006年1月51例临床可疑冠心病及体检患者接受40层螺旋CT心电门控增强扫描和常规冠状动脉造影的影像学资料.使用PHILIP 40层螺旋CT机,经肘静脉以3.5 ml/s～4.5 ml/s用双筒高压注射器注入优维显70～95 ml.在心电图R-R间期的75%、70%、45%、40%重建轴位图像,并进行容积成像、多平面重建、曲面重建、最大密度投影等后处理.结果 40层螺旋CT冠状动脉造影用于诊断冠状动脉中度以上狭窄的敏感性为84.3%,特异性为96%,阳性和阴性预测值分别为85.7%和95.5%.结论 40层螺旋CT冠状动脉造影是一种优良的冠状动脉成像方法,其高质量的CTA图像可作为临床筛查冠心病的可靠手段.

Application of 40-slices spiral CT to angiography of coronary artery

Objective To evaluate 40-slices spiral CT in the diagnosis of coronary heart disease (CHD). Methods 51 people suspected for CHD or attendants to health examination clinics underwent enhanced 40-slice spiral CT scanning and routine coronary angiography during October 2005-January 2006. Philips 40-slice spiral CT machine was used. 70-95ml of Iopromide(Ultravist) was administered via elbow vein at a speed of 3.5-4.5ml/s. Axis images were reconstructed at 75%, 70%, 45% and 40% R-R interval of ECG. Some post-treatments were conducted involving VRT, MPR, CPR and MIP. Results By referring to routine angiography as gold standard, 40-slice CTA had a sensitivity rate of 84.3% and specificity rate of 96% in diagnosing narrow- ness severer than moderate, the positive and negative estimate was 85.7% and 95.5% respectively. Conclusion 40-slice CTA is a good coronary angiography deserving a reliable method for screening CHD.