128层螺旋CT冠状动脉成像筛查冠状动脉病变的临床价值

目的以选择性冠状动脉造影（SCA）为标准，评价128层螺旋cT冠状动脉血管成像（CTA）诊断冠状动脉疾病（CAD）的临床价值。方法回顾我院52例做过冠状动脉CTA与SCA的冠心病患者，进行对照分析。结果128层螺旋cT冠状动脉CTA可获得较好的图像质量，52例患者中，CTA成像检出心肌桥16例，血管内斑块形成98处；17例一侧明显型优势冠状动脉，冠状动脉狭窄86支，包括轻度狭窄22支、中度狭窄24支、重度狭窄40支，SCA诊断心肌桥6例，冠状动脉狭窄84支，包括轻度狭窄22支、中度狭窄21支、重度狭窄41支。结论冠状动脉CTA与SCA相比，不仅能对冠状动脉粥样硬化的狭窄程度作出判断，还可以对粥样斑块的病理性质、斑块的稳定性以及心肌桥提出明确诊断，可以用于CAD的筛查，几乎能代替诊断性的冠状动脉造影。

Clinical applicative value of 128-SCT coronary CTA in the screening for coronary artery disease

Objective To evaluate the diagnostic value of 128-slice spiral computed tomography （128-SCT） for coronary artery disease by compaing with selective X-ray coronary angiography （SCA）. Methods Fifty-two cases of coronary artery disease with coronary angiography with CT （CTA）and selective X-ray coronary angiography （SCA）were analyzed retrospectively in order to do comparative analysis. Results 128-SCT coronary artery CTA could ob tain better image quality; the coronary CTA imaging detected myocardial bridge in 6 cases, intra-arterial plaques were assessed in 98 branches; 17 cases of coronary artery had advantage. There were 86 branches in coronary artery dis ease, including 22 with mild stenosis, 24 with moderate stenosis, 40 with severe stenosis. Of 16 cases diagnosed with coronary artery disease by SCA, 22 with mild stenosis, 21 with moderate stenosis, 41 with severe stenosis. Conclusion Compared with SCA, coronary CTA basically can not only indicate the nature of the various plaque pathology, but also judge the stability of plaque and the myocardial bridge, which can be used as the screening for coronary artery dis ease, being a substitute for diagnostic coronary angiography.