多排螺旋CT冠脉成像与冠脉造影对冠心病诊断的对比研究

目的:初步评价MSCT在冠状动脉成像中的临床应用价值。方法:18例疑诊冠状动脉狭窄患者行MSCT扫描,利用影像曲面重建,3D重建,了解冠状动脉病变情况,并与冠状动脉造影对比。结果:18例76支血管同时经MSCT和CAG成像。冠状动脉造影发现狭窄27支,其中左前降支(LAD)病变11支,回旋支(LCA)病变3支,左主干(LMA)2支,右冠(RCA)病变9支,桥支病变2支。MSCT发现狭窄23支,其中左前降支病变11支,回旋支病变3支,左主干病变1支,右冠病变9支,桥支病变2支。MSCT成像的敏感性为81．5％(22／27),特异性100％,阳性推测值91．7％,阴性推测值94．2％。结论:在控制心率的情况下,MSCT可作为冠状动脉狭窄的一种无创筛选检查方法。

A comparative study of coronary artery imaging with MSCT and coronary angiography in the diagnosis of coronary disease

Objective:To evaluate the clinical value of Multi-slice Spiral CT(MSCT) in the coronary artery imaging. Methods: MSCT was performed in 18 patients who were suspected of having stenosis of the coronary arteries. CT data were reconstruction including 3D curved MIP. The images obtained from the above procedures were used to evaluate the abnormalies of coronary arteries,and the results were compared with DSA angiography. Re-sults: In 76 arteries of 18 patients in whom both MSCT and DSA were done,27 stenosis of coronary arteries was diagnosed in 27 arteries with DSA,including 11 left anterior descending (LAD) ,3 left circufles artery (LCA) ,2 left main coronary artery (LMA),9 right coronary artery (RCA) and 2 coronary artery bridging branch (CABG). By means of MSCT,stenosis of 23 branches was found,such as 11 LAD,3 LCA, 1 LMA,9 RCA and 2 CABG. The total sensitivity of MSCT was 81. 5% ,and its specificity was 100%. Conclusion: With the heart rate controlled,MSCT can be used as a non-invasive screening method for the patients with suspected stenosis of the coronary artery.