多层螺旋CT冠状动脉造影的扫描技术及临床应用

目的：探讨多层螺旋CT冠状动脉造影的成像技术及临床应用价值。方法：对68例包括40例无明显心脏疾患的志愿者，25例冠心病患者，2例经皮冠冠状动脉成形术（PTCA）术后5个月和1例主动脉瓣膜置换术后的患者]进行了多层螺旋CT冠状动脉造影（multi-slice spiral CT coronary angiography,MSSCTCA)并行冠状动脉三维重建，其中25例冠心病患者并进行了选择性冠状动脉造影检查，以此为金标准，比较MSSCTCA对冠状动脉病变的检出率（未作冠状动脉造影的，只是用于评价多层螺旋CT对冠脉各支的显示能力，如显示哪几支、显示长度，示涉及有否冠状动脉疾患的显示）。结果：MSSCTCA对冠状动脉近中段显示清晰，显示率可达90％以上；对冠状动脉狭窄检出率为87．5％。结论：MSSCTCA可作为冠状动脉粥样硬化疾患的筛选手段及冠状动脉术后复查的首选方法。

Multi-slice spiral CT coronary angiography: technique and clinical applications

Objective To determine the optimal scan parameters and reconstruction methods and to demonstrate the possibilities and limitations of multi slice CT for contrast enhanced investigation of the coronary arteries. Methods A multi slice CT system with 4 simultaneously acquired slices and 0.5 sec rotation time was used (Siemens Somatom plus 4 Volume Zoom). Five 3D methods (VR, MIP, MPR, SSD, and CTVE) were used. A total of 68 patients underwent cardiac CT. In 25 patients with known or suspected CAD, CT was compared with quantitative coronary angiography. Results 90% of the coronary arteries could be visualized over long segments. On average, 2/3 of the main coronary arteries length could be visualized free of motion artifacts. Multi slice CT coronary angiography showed a high diagnostic accuracy in the detection and quantification of coronary lesion, and the sensitivity was 87.5%. VR was the best 3D reconstruction method for visualizing coronary artery. Conclusion This cardiac imaging method was simple, reliable, non invasive, low risk, comfortable, and non expensive. It has the potential to rule out CAD, permitting the evaluation of pre and post operative cardiovascular situation, coronary artery calcification screening and so on.