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

目的初步评价多排螺旋CT（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（CAG）对比。结果18例76支血管同时经MSCT和CAG成像。CAG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24支,其中LAD病变11支,LCA病变3支,LMA病变1支,RCA病变7支,桥支病变2支。MSCT与CAG结果相符的病变血管22支,MSCT成像的敏感性为82%（22/27）,特异性96%（47/49）。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。

Comparative study of multi-slice spiral CT coronary artery imaging and coronary angiography in diagnosis of coronary artery stenosis

AIM To evaluate the clinical value of Multi-slice Spiral CT (MSCT) coronary artery imaging in the diagnosis of coronary artery stenosis. METHODS MSCT and digital subtraction angiography (DSA) were conducted in 18 patients with suspected coronary artery stenosis. The abnormities of coronary arteries were evaluated from reconstructed three-dimensional and maximum intensity projection (MIP) images and the results were compared with those of DSA. RESULTS In the 76 arteries of 18 cases undergoing MSCT and DSA, 27 arteries were diagnosed as stenosis by DSA [including 11 left anterior descending arteries (LAD), 3 left coronary arteries (LAD), 2 left main coronary arteries (LMA), 9 right coronary arteries (RCA) and 2 coronary artery bypass grafts (CABG)] and by MSCT 24 arteries were diagnosed as the stenosis [including 11 LAD, 3 LAD, 1 LMA, 7 RCA, and 2 CABG]. Twenty-two artery stenoses were diagnosed by both MACT and DSA. The sensitivity and specificity of MSCT were 82% (22/27) and 96% (47/49), respectively. CONCLUSION With heart rate controlled, MSCT can be used as a noninvasive screening method in the diagnosis of coronary artery stenosis.