64排CT在急性胸痛诊断中的应用价值

目的:探讨64排CT对急性胸痛的诊断价值。方法:63例急性胸痛患者行64排CT回顾性心电门控胸部联合检查。采用MPR、MIP、CPR及VR等显示肺动脉、主动脉、冠状动脉及胸部、胸壁其他组织结构。由2名有经验的放射科医师对所有图像进行分析评价。结果:冠状动脉显影图像质量优占82.0%(672/820),良占12.9%(106/820),差占5.1%(42/820)。全部患者肺动脉和主动脉增强扫描后CT值≥200HU,均能达到诊断要求。心血管源性胸痛50例,其中冠状动脉病变29例,主动脉夹层11例,肺动脉栓塞8例,心包炎2例。非心血管源性胸痛7例,其中气胸3例,胸膜炎2例,肺部感染1例,食管疾病1例。6例未见异常。结论:64排CT胸部血管联合检查能清楚显示肺动脉、主动脉、冠状动脉,图像质量可以满足临床诊断要求,同时还能显示胸部其他疾病,在急性胸痛病因诊断中具有很高的临床应用价值。

The application value of 64-slice spiral CT in the diagnosis of acute chest pain

Objective： To explore the application value of thoracic vascular（pulmonary artery, thoracic artery, coronary artery） combined scan of 64-slice spiral CT in the diagnosis of acute chest pain. Methods：Sixty-three patients who presented with acute chest pain were included in the study. All of the patients were performed a one-time unified examination of pulmonary artery, coronary artery, aorta with 64-slice CT retrospective ECG-gated function. The pulmonary artery, aorta, coronary artery and oth- er anatomical structure of the chest were imaged by using a variety of recombinant techniques such as MPR, CPR, MIP and VR. All of the images were evaluated by 2 experienced radiologists. Results.. The image quality of 82.0% （672/820） coronary seg- ments was classified as excellent, 12.9% （106/820）as good,and 5.1 % （42/820） as poor. All the cases could satisfy the require- ment of diagnosis,because the CT values of the pulmonary artery and thoracic artery after enhancement were≥200 HU in all cases. There were 50 cases with cardiovascular disease,including coronary artery disease in 29 cases,aortic dissection in 11 ca- ses,acute pulmonary embolism in 8 cases,pericarditis in 2 cases. There were 7 cases with non-cardiovascular disease,including pneumothorax in 3 cases, pleurisy in 2 eases, pulmonary infection in 1 case, 1 case of esophageal diseases. There were no obvious abnormalities in 6 patients. Conclusion：The exam of 64-siice spiral CT chest angiography can clearly show pulmonary artery,a- orta and coronary artery. The image quality could meet the clinical diagnostic requirements. Meanwhile, a clear indication of chest diseases can be detected. It has great potential in the etiological diagnosis for the patients with acute chest pain.