64排螺旋CT冠脉成像与常规冠状动脉造影对比分析

目的分析64排螺旋CT冠脉成像与常规冠状动脉造影对比分析。方法选取我院2015年2月~2016年2月收治的冠心病患者31例为研究对象,对所有患者展开64排螺旋CT冠脉成像检查,同时给予常规冠状动脉造影检查,比较两类检测方式的有效性。结果 64排螺旋CT冠脉成像对于冠状埃及狭窄的具体诊断特异性以及敏感性分别为95.77%和97.14%,阴性预测率与阳性预测率分别为98.55%和91.89%。结论对冠心病患者采用64排螺旋CT冠脉成像技术具有较高的检测效果,具有临床推广价值。     

64排螺旋CT诊断冠状动脉病变的临床价值

目的评价64排螺旋CT用于诊断冠状动脉病变的临床价值。方法连续入选66名冠心病患者，均行64排螺旋CT冠脉三雏成像和冠状动脉造影，以冠状动脉造影的结果为“金标准”，计算64排螺旋CT诊断冠状动脉病变的敏感性，特异性，假阳性率，假阴性率，阳性预测值，阴性预测值。结果对照冠状动脉造影，64排螺旋CT诊断冠脉病变的敏感性为93．02％，特异性为98．21％，假阳性率为1.79％，假阴性率为6．98％，阳性预测值为97．56％，阴性预测值为94．83％。结论64排螺旋CT对于诊断冠脉病变有较好的敏感性与特异性，可用于冠心病患者的筛查。但目前的技术水平和各项技术指标仍有待提高，还无法替代传统的血管造影。     

64排螺旋CT冠脉成像对老年冠心病诊断价值研究

目的 评价64排螺旋CT冠状动脉成像在老年冠心病诊断中的价值.方法 对460例疑诊老年冠心病患者行64排螺旋CT冠脉成像,2周内行选择性冠状动脉造影(CAG)进行对比,对64排螺旋CT显示的冠状动脉主支及其主要分支情况进行分级评估.结果 460例患者4255支冠状动脉中,显示病变868支,其中781支与CAG结果 吻合,60支64排螺旋CT诊断狭窄而CAG显示正常,另外有2例CAG确诊存在病变而在64排螺旋CT冠状动脉成像未能显示,2种检查方法 在发现冠状动脉疾病方面无统计学差异(P＞0.05).在显示病变程度上,共781支病变在程度上与CAG结果 吻合,准确性为89.98%.结论 64排螺旋CT显示冠脉病变具有较高的敏感性和特异性,对病变的程度评估较为准确,适合用于临床怀疑冠心病的老年患者的筛查.     

64排螺旋CT评定冠心病PCI术后支架内再狭窄的价值

目的:探讨64排螺旋CT诊断冠心病患者PCI术后支架内再狭窄(ISR)的价值。方法:120例冠心病PCI术后患者分别接受64排螺旋CT冠状动脉成像检查和常规冠状动脉造影(CAG)检查,对冠状动脉支架再狭窄进行评估。结果:以CAG作为金标准,64排螺旋CT冠状动脉成像检查诊断ISR阳性的敏感性、特异性、阳性预测值、阴性预测值分别为87.5%、95.3%、80.0%、97.3%。结论:64排螺旋CT冠脉成像诊断冠脉支架再狭窄的敏感性和准确性较高,可作为冠状动脉支架植入术后患者随访的无创性手段之一。     

冠心病采用64排螺旋CT冠脉成像和冠脉造影的比较

目的分析64排螺旋CT冠脉成像和冠脉造影运用于冠心病中的诊断价值。方法选取2015年8月~2016年9月我院收治的疑诊冠心病患者80例作为研究对象。以冠状动脉造影的结果当作金指标,运用64排螺旋CT对其冠脉主干以及主要的分支进行重建与分析,对其诊断的特异性与灵敏性进行评价。结果 64排螺旋CT可以将冠脉主干以及其桥血管病变、开口起源异常、钙化、狭窄等情况清晰地显示出来,具有非常高的诊断准确性。结论 64排螺旋CT冠脉成像能良好的显影出冠脉狭窄病变、支架管腔、桥血管以及心肌桥等,与冠脉造影相比,在钙化病变的诊断中具有更高的准确率,值得临床推广使用。     

64排螺旋CT冠状动脉成像在冠心病诊断中的价值研究

目的探索64排螺旋CT冠状动脉成像在冠心病诊断中的价值。方法选取2013年1月~2016年1月收治的疑似冠心病患者70例为研究对象,对所有患者实施64排螺旋CT冠状动脉成像检查,分析其诊断价值性。结果 64排螺旋CT冠状动脉成像检查在冠心病患者中的敏感性、漏诊率、误诊率、特异性分别为96.00%、4.00%、5.00%、95.00%,其诊断结果和冠状动脉造影诊断结果无差异性。结论 64排螺旋CT冠状动脉成像应用于冠心病患者中,具有较高的特异性和敏感性,可降低临床误诊率和漏诊率,临床效果显著,值得推广。     

64排螺旋CT对冠心病患者钙化病变的诊断评价

多排螺旋 CT成像技术的不断进步使其在冠心病无创诊断方面的作用日渐重要.伴随着64 排螺旋CT的普及,其在成像和诊断中所面临的问题,特别是钙化病变对多排CT冠状动脉成像狭窄准确性判断的影响问题越来越为人们所关注.本文通过对有明显钙化血管段的冠状动脉血管成像(CTA)影像结果进行诊断试验评价(以冠脉造影为金标准),从而明确钙化病变对多排CT冠状动脉成像狭窄准确性判断的影响,及CTA评估钙化冠脉管腔狭窄程度的价值.     

64排螺旋CT冠脉成像在冠心病诊断中的应用价值

目的 评价64排螺旋CT冠脉成像在冠心病诊断中的应用价值.方法 82例患者分别进行64排螺旋CT增强扫描和经皮冠状动脉血管造影术,始终由两位不知造影结果的医师进行阅片,并且根据冠脉血管造影结果作为标准进行对比分析.结果64排螺旋CT判断不同部位冠脉血管狭窄(管腔狭窄≥50％),对于左冠主干狭窄的诊断和冠脉造影相同,其特异度和灵敏度均为100.0％;对于左前降支狭窄的诊断的灵敏度和特异度次之,均为95.2％;左回旋支和右冠狭窄的诊断灵敏度最低.结论 64排螺旋CT对冠状动脉成像质量高,对狭窄的诊断能力强,是目前冠状动脉痛变最理想的无创检查方法之一,有较高的临床应用价值.     

64排螺旋CT对冠心病的诊断价值分析

目的：探讨64排螺旋 CT 冠脉成像（CTA）对冠心病的诊断价值。方法分析2012年12月-2013年12月确诊或疑诊冠心病患者,在本院进行64排螺旋CT冠脉成像检查,行冠脉造影术的200例患者影像学资料,将64排CT冠脉成像结果与冠脉造影结果进行比较,评价其敏感性、特异性、阳性预测值、阴性预测值及两种检查手段对不同程度狭窄的评估对比。结果64排螺旋CT冠脉成像判断血管≥50%狭窄的敏感度94.04%,特异度93.96%,阳性预测值90.80%,阴性预测值96.46%。对冠脉狭窄程度的评估也与冠脉造影相当。结论64排螺旋CT冠脉成像对冠心病的诊断有很高的敏感性、特异性、阳性预测值、阴性预测值,具有广泛的临床应用价值。     

冠脉64排螺旋CT与腺苷负荷心肌灌注显像对冠心病的诊断价值

目的：探讨冠脉64排螺旋CT（CTA）与腺苷负荷心肌灌注显像对冠心病的诊断价值。方法：入选临床诊断或疑诊为冠心病的患者66例,以冠状动脉造影作为冠心病诊断的金标准,所有患者均进行冠脉64排螺旋CT,腺苷负荷心肌灌注显像与冠状动脉造影检查。结果：与冠状动脉造影比较,64排螺旋CT对冠心病诊断的敏感性为87.10%（27/31）,特异性为97.14%（34/35）,准确性为92.42%（61/66）,腺苷负荷心肌灌注显像敏感性为93.55%（29/31）,特异性为85.71%（30/35）,准确性为89.39%（59/66）。冠脉64排螺旋CT与腺苷负荷心肌灌注显像在诊断冠心病的准确性上无显著差别（P〉0.05）。结论：冠脉64排螺旋CT与腺苷负荷心肌灌注显像诊断冠心病的准确性无显著差别,结果可靠,应予推广。     

Right coronary artery coronary sinus fistula with coronary sinus ostium stenosis

Coronary artery fistula (CAF) is a rare anomaly of the coronary artery. The draining site of a right coronary artery (RCA) fistula may usually be the right ventricle, right atrium, or pulmonary artery. Here, we present a patient with right coronary artery to coronary sinus fistula (RCACSF) complicated by aneurysmal dilatation of the coronary sinus (CS) and stenosis of CS ostium.     

Iatrogenic coronary artery stenosis following coronary stenting

We present 6-month follow-up of 435 patients undergoing stent deployment. Forty-four patients were referred because of myocardial ischemia related to the stented artery. In six of these patients (14%), the stented vessel revealed a new proximal lesion separated from the stented portion, which warranted further intervention. It is felt that these new lesions are related to the stenting technique as a result of local trauma induced from the guiding catheter. Cathet. Cardiovasc. Intervent. 46:393–397, 1999. © 1999 Wiley-Liss, Inc.     

Atherosclerosis of coronary arteries, coronary heart disease and sudden coronary death

Correlation between the severity of coronary atherosclerosis, thrombosis and sudden cardiac death was examined in 721 autopsied cases. Severe coronary atherosclerosis with stenosis was found in most of them; however a similar grade of atherosclerosis was discovered in patients with ischaemic heart disease not dying suddenly. Acute coronary thrombosis in the studied subjects was diagnosed post mortem in about 20 percent of those who died suddenly. Other studies indicate frequencies between 4-93%. There was no consistent time dependence.     

Pseudoaneurysm of coronary artery following rupture of coronary artery during coronary angioplasty.

Rupture of the coronary artery is a rare complication of percutaneous transluminal coronary angioplasty (PTCA). We describe a case of coronary artery rupture during PTCA resulting in the formation of a coronary artery pseudoaneurysm. The pseudoaneurysm was successfully treated by percutaneous spring-coil embolization of the coronary artery.     

Complex coronary angioplasty: Multiple coronary dilatations

Selected patients underwent PTCA of multiple stenoses in different vessels or in the same vessel. Three hundred nine patients underwent 685 PTCA procedures in various combinations of arterial and vein graft stenoses. A multiple dilatation procedure was defined as successful when all lesions attempted were successfully dilated, or when the considered-critical-stenosis was successfully dilated and this resulted in a patient clinical improvement. Angiographic success was achieved in 599 of 685 lesions attempted (87.4%) and in 285 of 309 patients (92.2%). Complications included a mortality rate of 1.0%, an MI rate of 4.2% per patient and 1.9% per lesion attempted, and a 3.6% incidence of emergency CABG. Follow-up data show that 58 patients (20.4%) had clinical evidence of a lesion recurrence, and that 92.5% (37 of 40 patients) who underwent repeat angioplasty had a successful procedure. A sustained clinical improvement was obtained in 264 of 309 patients (85.4%). The data indicate that multiple dilatations are feasible with good success rates and acceptable complication rates. Further evaluation of this extended application of PTCA is needed to clearly establish its role in the therapy of CAD.     

Serial quantitative coronary angiography and coronary events

BACKGROUND: Although assessment of progression of atherosclerosis by quantitative coronary angiography (QCA) is used as a surrogate for coronary events, no validation study has compared the several QCA measures used. METHODS AND RESULTS: The Cholesterol Lowering Atherosclerosis Study was a clinical trial testing the efficacy of colestipol-niacin on the progression of coronary atherosclerosis. Baseline/2-year coronary angiograms were obtained on 156 men with prior coronary artery bypass graft surgery. Changes in percent diameter stenosis and minimum lumen diameter (both measured in coronary lesions and segments) and coronary segment measures of average diameter, percent involvement, and vessel edge roughness were measured by QCA. Coronary events ascertained over 12 years of follow-up included myocardial infarction (MI), coronary death, and coronary artery revascularizations. Proportional hazards models evaluated the relation between QCA change measures and coronary events. Changes in percent diameter stenosis and minimum lumen diameter of coronary artery lesions were significantly related to the risk of MI/coronary death. All QCA measures were significantly related to the risk of any coronary event. Relative risks for each QCA measure were of similar magnitude when estimated separately within each treatment group. Change in minimum lumen diameter of lesions was the only measure independently associated with the risk of coronary events. CONCLUSIONS: All QCA measures of progression of coronary artery disease were related to all coronary events (including revascularizations). Only QCA measures of lesion progression were related to MI/coronary death. QCA measures of lesion change may be better surrogate end points for "hard" coronary events than measures of change in coronary segments.     

Percutaneous coronary intervention of bifurcation coronary disease

Bifurcation coronary artery disease is a frequent problem faced by interventional cardiologists and it affects approximately 15-20% of patients undergoing percutaneous coronary intervention (PCI). The application of drug-eluting stents (DES) technology to prevent restenosis after PCI represents one of the success stories in cardiology, but DES have not resolved the bifurcation PCI challenge. Bifurcation PCI remains associated with higher procedural failure and worse outcomes compared with PCI of non-bifurcated lesions even in DES era. A dependable strategy for PCI of bifurcation lesions has yet to be established, which is likely due to the paucity of studies evaluating the anatomical intricacies of the bifurcation as well as the lack of large scale randomized therapeutic trials. Further, bifurcation has many anatomical variants and it is unlike that one technique will fit all. Currently, we are left with the option of a tailor-made strategy for each patient and bifurcation anatomy and make the most of the limited evidence available to support our therapeutic decisions. In this review, we attempted to describe the current understanding of bifurcation anatomy and corresponding PCI strategies.