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主动脉缩窄及主动脉弓离断的电子束CT诊断 总被引:12,自引:0,他引:12
目的:探讨电子束CT诊断先天性主动脉缩窄和主动脉弓离断的价值。材料和方法:共10例病人,年龄6—18岁,均经手术证实。对所有患儿行EBCT增强扫描,并对图像行三维重建。结果:10例病人术前均得到正确诊断,其中8例为主动脉缩窄,2例为主动脉弓离断。EBCT均显示了全部8例主动脉缩窄及其缩窄的程度、形态,并显示缩窄处与左锁骨下动脉的关系。其中6例(75%)为局限性狭窄,2例(25%)形成中-重度长管状狭窄。合并畸形有:3例合并动脉导管未闭,1例合并室间隔缺损,1例合并肺动脉狭窄,1例合并二尖瓣狭窄,2例同时合并动脉导管未闭和室间隔缺损。2例主动脉弓离断病例,均合并有动脉导管未闭、室间隔缺损和肺动脉狭窄。EBCT均显示升主动脉与降主动脉呈分离状。结论:EBCT作为一种无创性检查方法,对先天性主动脉病变的诊断有重要价值,并能同时显示合并的胸部大血管异常。 相似文献
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Ali A Haydar Nabil M A Hujairi Adrian A Covic Divaka Pereira Michael Rubens David J A Goldsmith 《Nephrology, dialysis, transplantation》2004,19(9):2307-2312
BACKGROUND: Coronary artery calcification (CAC) measured by electron beam computed tomography (EBCT) correlates with plaque burden, vessel stenosis and is predictive of future cardiac events in the general population. Extensive CAC has been described recently in dialysis cohorts. For the first time we studied the relationship between CAC and coronary angiographic findings in patients with chronic renal failure, on dialysis and after renal transplantation. METHODS: We studied 46 patients who all had an EBCT-derived Agatston coronary calcium score and a diagnostic coronary angiogram within a 12-month period. The mean age was 55.7+/-13.2 (SD) years (range 29-80). The mean duration of dialysis was 54.4 months (range 1-372). RESULTS: The mean CAC was 2370+/-352.8. The mean CAC in patients with an abnormal coronary angiogram (n = 35) was 2869.6+/-417.9, while that in patients with a normal coronary angiogram (n = 11) was 559.4+/-255.1 (P = 0.001 for the inter-mean comparison). Total CAC correlated with the number of diseased vessels (P = 0.0001) and with severity of atherosclerosis in all the vessels (P = 0.0001). The individual coronary artery calcification score correlated well with the severity of atherosclerotic coronary disease (P<0.0001 for all) in the left anterior descending, right coronary and circumflex arteries. Running a multivariate regression analysis for atherosclerosis burden, we found that the only predictor was CAC (r = 0.34, P = 0.0001). CONCLUSION: CAC is common and more severe in patients with chronic kidney disease. Although in chronic kidney disease patients CAC can occur in the absence of occlusive coronary atherosclerosis, our data suggest that, as in the general population, CAC in chronic kidney disease patients is associated with obstructive atherosclerosis and may therefore be associated with a worse outcome. 相似文献
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K. Bendix J.M. Jensen S. Poulsen N. Mygind B.L. Nørgaard 《European journal of radiology》2011,80(1):109-114
Objectives
(1) To establish the prevalence of incidental extra-cardiac findings (ECFs) in coronary multi detector computed tomography (CCT) performed in a large, homogeneous cohort of patients suspected of coronary artery disease (CAD). (2) To examine whether any association can be established between ECFs and pretest risk as determined by conventional risk factors for CAD, the Diamond-Forrester risk model or coronary artery calcium scores. (3) To assess cost related to extra-cardiac examinations.Design
Retrospective study of consecutive patients who had CCT performed. A large field of view was recreated from the non-enhanced CT scan and evaluated by a radiologist for incidental ECFs.Subjects
Patients with chest pain referred to CTA by a cardiologist.Results
In 1383 patients a total of 481 ECFs were indentified, 378 minor (meaning no follow-up was needed) and 103 major ECFs (ECF followed up clinically and/or with additional imaging), in a total of 393 (28%) patients. 85 (6%) patients had one major ECF and 9 (0.7%) patients had two major ECFs. In 19 (4 cases of malignancy) patients the major ECF had therapeutic consequences. Significant positive associations were found between age and smoking, respectively and the presence of ECFs. The cost estimate of saving one life from malignant disease based on ECF examinations is 40,190€.Conclusion
Incidental extra-cardiac findings are common, sometimes revealing serious, even malignant disease. Diagnostic follow-up of major ECFs seems to be cost-effective in a Danish clinical setting. We recommend investigating a large field of view for incidental ECFs following CCT. 相似文献7.
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Geluk CA Dikkers R Perik PJ Tio RA Götte MJ Hillege HL Vliegenthart R Houwers JB Willems TP Oudkerk M Zijlstra F 《European radiology》2008,18(2):244-252
We determined the efficiency of a screening protocol based on coronary calcium scores (CCS) compared with exercise testing
in patients with suspected coronary artery disease (CAD), a normal ECG and troponin levels. Three-hundred-and-four patients
were enrolled in a screening protocol including CCS by electron beam computed tomography (Agatston score), and exercise testing.
Decision-making was based on CCS. When CCS≥400, coronary angiography (CAG) was recommended. When CCS<10, patients were discharged.
Exercise tests were graded as positive, negative or nondiagnostic. The combined endpoint was defined as coronary event or
obstructive CAD at CAG. During 12±4 months, CCS≥400, 10–399 and <10 were found in 42, 103 and 159 patients and the combined
endpoint occurred in 24 (57%), 14 (14%) and 0 patients (0%), respectively. In 22 patients (7%), myocardial perfusion scintigraphy
was performed instead of exercise testing due to the inability to perform an exercise test. A positive, nondiagnostic and
negative exercise test result was found in 37, 76 and 191 patients, and the combined endpoint occurred in 11 (30%), 15 (20%)
and 12 patients (6%), respectively. Receiver-operator characteristics analysis showed that the area under the curve of 0.89
(95% CI: 0.85–0.93) for CCS was superior to 0.69 (95% CI: 0.61–0.78) for exercise testing (P<0.0001). In conclusion, measurement of CCS is an appropriate initial screening test in a well-defined low-risk population
with suspected CAD. 相似文献
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Chen Huang Xiaoming Wang Jianyuan Gao Hua Meng Liping Wu Rong Li Hui Su Hua Zhang Ronghuai Zhang Minwen Zheng 《老年心脏病学杂志》2007,4(3):155-161
Objective To assess the prevalence and risk of coronary artery disease(CAD) in Chinese adults with type 2 diabetes mellitus(T2DM) using electron beam computed tomography(EBCT) and EBCT angiography(EBCTA) . Methods:Ninety-four cases were enrolled in this study including diabetes(n=28) ,impaired glucose tolerance(IGT,n=30) ,coronary heart disease(CHD,n=11) ,and control(n=25) . Cardiac EBCT plain scanning and EBCTA were performed on all of these subjects to evaluate coronary artery calcifica-tion(CAC) scores,and number of segments of stenosed coronary arteries. Both CAC and/or coronary artery stenosis were defined as patients with coronary artery lesions(CAL) . Results CAC scores were not different with the control,diabetes,IGT,or CHD(P>0.05) groups. Compared to control(0.520±1.295) ,more stenosed coronary arteries segments(P<0.05) were detected in diabetes(2.964± 1.915) ,IGT(2.200±2.024) ,and CHD(2.273±1.679) . Number of stenosed artery segments were correlated with age(r=0.215,P=0.019) ,postprandial glucose(r=0.224,P=0.015) ,total cholesterol(r=0.323,P=0.000) ,and duration of diabetes(r=0.208,P=0.004) . The incidences of CAL in diabetes(96.43%) ,IGT(93.33%) ,and CHD(90.91%) was substantially higher than that in normal control(56.00%,P<0.01) . The odds ratio of CAL associated with having diabetes was estimated to be 7.514(95% CI:1.885-63.778) . Conclusions Coronary artery lesions are prevalent in Chinese adults with type 2 diabetes,implying a high CAD risk. EBCTA holds potential in depicting the details of CAL and can be used to track the progression of CAD in diabetes patients. 相似文献
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电子束CT三维重建在髁突骨折中的应用评价 总被引:6,自引:3,他引:3
目的:探讨电子束CT(EBCT)三维重建在髁突骨折中的应用价值。方法:髁突外伤患者11例,均给予临床检查、摄X线片、EBCT平扫及三维重建检查,评估髁突骨折的类型及骨折移位程度、选择适合的治疗方案。结果:EBCT具有扫描速度快、图像清晰的特点,其三维影像可以任意旋转和切割,从不同角度观察病变情况,正确地显示髁突骨折及其类型。结论:EBCT平扫及三维重建能客观地提供髁突骨折的所有特征,将两种以上重建方法结合,可以更清晰地显示和反映骨折线走向、碎骨片的移位,提高了髁突骨所的诊断和显示率,降低了误诊率,为制订治疗方案提供准确信息。 相似文献