双源CT冠状动脉成像评价冠状动脉搭桥术后桥血管通畅情况

目的探讨双源 CT 冠状动脉成像对冠状动脉搭桥术后桥血管通畅状况的诊断价值.资料与方法38例患者于冠状动脉搭桥术后行双源 CT 冠状动脉成像与冠状动脉造影检查,以冠状动脉造影作为“金标准”,对双源 CT 冠状动脉成像结果进行分析.结果38例患者共检出桥血管92支,其中内乳动脉桥31支,大隐静脉桥61支;31支内乳动脉桥中,26支(83.9%)桥血管通畅,5支(16.1%)管腔狭窄、闭塞;61支大隐静脉桥血管中35支(57.4%)桥血管通畅;26支(42.6%)管腔狭窄、闭塞.大隐静脉桥血管狭窄、闭塞的发生率明显高于内乳动脉桥血管(P<0.05).双源 CT 冠状动脉成像评价桥血管狭窄、闭塞的敏感性为93.9%,特异性为100.0%.结论双源 CT 冠状动脉成像对冠状动脉搭桥术后桥血管通畅状况的评价有较高的诊断价值,是一种快速、无创、准确、安全的检查方法.

Evaluation of Coronary Bypass Grafts Using Coronary Angiography with Dual-source CT

Purpose To investigate the value of dual-source CT in evaluating patency of bypass in patients after coronary artery bypass graft surgery. Materials and Methods Thirty eight consecutive patients who underwent coronary artery bypass graft surgery received selective coronary angiography (CAG) and coronary angiography on dual-source CT (CTA). Results All of the ninety two bypass grafts were successfully reconstructed by workstation. Of 31 internal mammary artery grafts, there were 26 patent grafts (83.9%), 5 restenosis or occlusive grafts (16.1%). Of 61 saphenous vein grafts, 35 grafts (57.4%) were patent, 26 grafts (42.6%) were restenosis or occluded. The rate of patency of internal mammary artery was statistically lower than that of saphenous vein graft (P<0.05). In contrast with CAG, sensitivity and specificity was 93.9% and 100.0% for dual-source CT to identify restenosis and occlusion in bypass grafts. Conclusion Dual-source CT is a noninvasive effective method for detecting the patency of veins and arteries after coronary bypass surgery.