16层螺旋CT冠状动脉成像技术的临床应用

目的评价16层螺旋CT在显示冠状动脉病变中的价值和限度。方法2004年4月—2005年9月连续选择300例临床诊断或可疑冠心病的患者做16层螺旋CT冠状动脉成像检查(回顾性心电门控、0.5s螺旋扫描、单或双扇区重建算法和静脉注射对比剂),并对300例患者的2364冠状动脉节段进行影像学评价。其中63例做了冠状动脉造影检查,对该63例患者的446冠状动脉节段进行了16层CT与冠脉造影结果的对照分析。结果在300例患者冠状动脉的2364节段(血管直径≥2mm)中1965(1965/2364,83%)个节段能满足影像评价,399(399/2364,17%)个节段不能满足影像的评价。冠脉造影显示正常或轻度狭窄、中度狭窄(<50%)的节段,CT有179(179/212)84.6%的节段与其分级一致;显示重度狭窄(>70%)的节段,CT有218(218/234)93.2%的节段与其分级一致。结论16层CT冠状动脉成像是一种无创、简便的检查方法,显示有临床意义的冠状动脉狭窄的准确性很高,且在观察冠状动脉的解剖及变异、冠状动脉支架术后、冠状动脉搭桥术后复查以及冠状动脉肌桥的显示等方面具有很高的价值。

Clinical Application of 16-detector Row Spiral CT to Coronary Disease

Objective To evaluate the value and limit in display coronary disease with 16-detector row spiral CT. MethodsA total of 300 patients with suspected or clinically diagnosed coronary artery disease were studied using 16-detector row spiral CT. Among them 63 ones underwent conventional coronary angiography, and their outcomes were compared with those of coronary angiography. ResultsAmong the 2,364 segments of the 300 patients, 1965 (1965/2364, 83%) satisfied imaging evaluation, but the other 399 segments did not. CT demonstrated 179 segments (179/212, 84.6%) in consistency with those of conventional coronary angiography for assessing normal, slight and moderate stenoses (stenosis<50%), and demonstrated 218 segments (218/234, 93.2%) as severe stenoses. ConclusionIt is suggested that 16-detector row spiral CT (or multiple spiral CT, MSCT) coronary angiography is a noninvasive and convenient examining method with accurately displaying clinical coronary artery stenoses. It also has a high value in displaying the anatomy and the variation, especially for the evaluation of post-PTCA and post-CABG (coronary artery bypass grafts).