多层面螺旋CT冠状动脉成像在冠心病中的应用

目的　评价多层面螺旋CT(MSCT)行冠状动脉血管造影和三维重建在冠心病中的应用价值。方法　对 30例冠心病患者进行了心电门控MSCT增强扫描 ,在工作站对图像资料进行了最大密度投影法 (MIP)三维重建 ,并与冠状动脉造影结果相对照。结果　 30例患者中对 12 0支冠状动脉血管 (左主干、左前降支、回旋支、右冠状动脉 )进行了MSCT三维重建 ,图像质量良好者为 84支 (70 % ) ,影响图像质量的主要因素是心脏搏动造成的伪影 ;9例冠状动脉支架和 5例冠状动脉搭桥术后均可清晰显示支架和血管桥的位置及远端血流情况 ,对于显示近中端高度 (>75 % )或完全梗阻性病有一定的准确性 (敏感性 80 % ,特异性 79.8% )。而不能显示轻度狭窄病变、远端或细小分支病变。结论　MSCT血管造影和三维重建在冠心病诊断和对病变血管的评价 ,以及血运重建术后复查等方面有一定的应用价值。

The application of coronary angiography by multislice spiral computed tomography in patients with coronary heart disease

Objective To evaluate the value of coronary angiography and 3 dimensional reconstruction by multislice spiral computed tomography(MSCT) in patients with coronary heart disease,and to analyze the factors affecting the image quality.Method Thirty patients with sinus rhythm were studied by contrast enhanced,electrocardiographically gated MSCT,and compared with coronary artery angiography.Results Of total 120 coronary arteries(left main,left anterior descending,left circumflex and right coronary artery),84 were well demonstrated(70%).Artifact caused by heart motion was the most important factor affecting the image quality.The coronary stents and bypass graft were well showed,and the proximal and severe lesions of coronary artery could be detected(sensitivity=80%,specificity=79.8%).Conclusion Coronary angiography and 3 dimensional reconstruction by MSCT are the methods helpful to the diagnosis of coronary artery disease and reexamination after revascularization.