64层螺旋CT在冠状动脉搭桥术后随访中的初步应用

目的:评价64层螺旋CT在冠状动脉搭桥术后随访中的应用价值.方法:14例搭桥术后患者行64层螺旋CT冠状动脉造影检查,分别评价CT图像桥血管近远端吻合口、桥血管本身和吻合口远端引流血管的图像质量及冠状动脉图像质量.有选择性冠状动脉造影作对照的病例,评价CT诊断桥血管通畅性和冠状动脉是否存在狭窄的可靠性,以管腔狭窄大于50%作为诊断血管狭窄的指标.结果:14例患者共发现桥血管33根,桥血管近远端吻合口可评价率分别为93.9%(31/33)和90.9%(30/33);桥血管本身近、中、远三段的可评价率分别为97.0%(32/33)、100%(33/33)和97.0%(32/33);远端引流血管的可评价率为93.9%(31/33).CTA共显示冠状动脉139段,冠状动脉节段可评价率为69.1%(96/139).CTA对评价桥血管的通畅性和冠状动脉是否存在狭窄未出现假阳性及假阴性结果.结论:64层螺旋CT在冠状动脉搭桥术后随访中具有重要的临床应用价值.

Preliminary Application of 64-row Multi-detector CT in the Follow-up of Coronary Artery Bypass Grafts

Objective:To evaluate the performance of 64-row multi-detector CT (MDCT) in the follow-up of coronary artery bypass grafts.Methods:14 patients with coronary bypass grafts underwent the 64-row MDCT coronary angiography (CTA).The proximal and distal anastomosis,the bypass graft itself,and the run-off vessel detected in CTA images were evaluated for every coronary bypass graft,and the native coronary artery segments were evaluated too.If there were conventional coronary angiography (CAG) records of the same patients,the reliability of the 64-row MDCT detecting stenoses of the bypass grafts and the native coronary segments would be evaluated.The standard for diagnosing stenosis was more than 50% reduction of the lumen diameter.Results:The rates of the proximal and distal anastomosis that could be evaluated were 93.9% (31/33) and 90.9% (30/33),respectively.The rates of bypass grafts themselves (proximal,medial and distal) that could be evaluated were 97.0% (32/33),100% (33/33) and 97.0% (32/33),respectively.And the rates of the run-off vessels and coronary segments that could be evaluated were 93.9% (31/33) and 69.1% (96/139),respectively.There were no false positive and false negative results in diagnosing stenosis of the bypass grafts and the native coronary segments.Conclusion:64-row MDCT has a high value in the follow-up of coronary artery bypass grafts.