64排螺旋CT冠状动脉评价及伪影原因分析

目的：探讨64层螺旋CT冠状动脉成像及伪影原因,评价其在冠状动脉病变筛查中的价值。方法62例疑似和确诊冠心病患者行64层螺旋CT冠状动脉成像,仔细准备,检查准备情况与图像质量进行对照分析。利用多种后处理方法对冠状动脉及其分支进行分析。以血管造影（DSA）作对照,对比分析诊断的敏感性、特异性和准确性。结果62例患者中58例进行了检查,4例失败。58例中有2例图像不能达到诊断要求,8例伪影明显但能达到诊断要求,48例轻度伪影或无伪影,图像结果满意。心率在65次/min以下者阶梯伪影明显减轻。56例检查成功者共分析血管节段672个,发现变异6处,病变128处。与DSA比较（12例）,显示率94.3%,总体判断敏感性92.0%,特异性90.2%,准确性89.9%。结论检查前准备是64层螺旋CT冠状动脉成像成败关键。64层螺旋CT冠状动脉检查可作为一种有效的筛查和随访手段应用于临床。

Evaluation of coronary artery imaging with 64 slice spiral CT and reason analysis of artifact

Objective To explore the coronary artery with 64 slice spiral CT and reason of artifacts to evaluate its value in diagnosis of coronary artery lesions. Methods Performed 64-slice spiral CT for 62 patients with known or suspected coronary artery disease, careful preparation was performed, A compared study between the preparation and the quality of the image was taken. Several reconstruction Methods were used to analyze coronary artery and it’s braches. Sensitivity, specificity and accuracy were analyzed respectively compared with DSA. Results 58 patients were performed CTA scan, 4 patients failed, 2 patients had poor image quality and could not be used to met the purpose of diagnosis. 8 patients had obvious artifacts, but could be used to make diagnosis, 48 patients had slight artifacts or no artifacts. Slight stepladder artifacts would be found when the heart rate bellow 65/min. 672 artery segment were analyzied, 6 artery variation and 128 artery lesions were found in 56 patients. Compared with DSA（12 case）, the display rate was 94.3%, sensitivity was 92.0%, specificity was 90.2%, accuracy was 89.9%. Conclusion The most important thing of coronary artery imaging is the preparation before examination. The coronary artery imaging of 64 slice spiral CT is a reliable noninvasive diagnostic method for coronary artery disease. It can be used as a screening method in the diagnosis of coronary artery disease.