16层螺旋CT冠状动脉血管造影临床应用探讨

目的 探讨多层螺旋CT冠脉造影(multislice spiral CT coronary angiography，MSCTCA)的成像技术及其临床应用价值。方法 对79例对象行MSCTCA检查，利用多种重建方法进行重建，分析影响冠脉成像质量的重要因素，MSCT对冠脉的显示能力，冠脉斑块性质及钙化程度，评价管腔狭窄及其程度，并对桥血管和支架的显示及通畅性进行评价。结果 左冠脉主干及前降支重建的最佳时相为75％R-R时相，左回旋支及右冠脉为62．5％R—R时相。以75%的相位窗重建得到容积再现的图像为最佳。MSCTCA对冠脉1～3级分支、甚至部分4级分支显示清晰，对冠脉斑块显示良好，对冠脉狭窄显示较佳，对搭桥血管及内支架显示良好：结论 16层MSCTCA可作为冠心病的筛选手段及在血运重建术后复查中有很高的临床应用价值。

Clinical application of 16-slice spiral CT coronary angiography]

OBJECTIVE: To assess the clinical value of multislice spiral CT coronary angiography (MSCTCA). METHODS: Totally 79 patients were examined with MSCTCA and the CT images were reconstructed by several methods to analyze the factors crucial for the image quality, the ability of MSCT displaying the coronary artery vessels, along with the nature and calcification degrees of the plaques. The presence as well as the degree of vascular stenosis, visualization of the bypass graft, implanted stents and patency of the vessels were evaluated. RESULTS: The left main coronary artery and the left anterior descending artery were all best visualized in 75% R-R phases while the right coronary artery and the left circumflex artery in 62.5% R-R phases. CT images obtained by volume rendering showed the best quality at 75% R-R phases. 16-slice spiral CT was able to display from the primary to the tertiary, and even the quaternary branches of the coronary artery, and clearly displayed the coronary plaques, stenosis, implanted stents and bypass grafts. CONCLUSION: MSCTCA has a good clinical value in the primary identification of coronary heart disease and reexamination after revascularization.