不同重建技术在多排螺旋CT冠状动脉造影中的应用  

Application of Different Reconstruction Techniques in Multidetector Spiral CT Coronary Angiography

作　　者：方文春 龚静山 夏丽天 吴斌 邱洁玲 袁旭春[3] 

机构地区：[1]深圳市保健办专家门诊部放射科,广东深圳518020 [2]深圳市人民医院放射科 [3]深圳市孙逸仙心血管医院放射科

出　　处：《实用放射学杂志》2004年第10期931-934,共4页Journal of Practical Radiology

基　　金：深圳市科技计划项目 (编号 [2 0 0 4 ] 1 31号 )。

摘　　要：目的　探讨不同重建技术在多排螺旋CT冠状动脉造影中的应用。方法　对 5 0例临床怀疑冠心病的患者采用西门子 16排螺旋CT行冠状动脉造影检查 ,应用容积再现漫游 (volumerenderingtechnique ,VRT) ,多平面重建 (multiplanarrecon struction ,MPR) ,曲面重建 (curvedplanarreconstruction ,CPR)和最大密度投影 (maximumintensityprojection ,MIP)等 4种技术重建。结果　冠状动脉钙化积分分析 ,冠状动脉有不同程度的钙化 19例 ;无钙化但有软斑块 4例 ;冠状动脉 1、2级分支显示率 10 0 %,3级以上分支显示为 60 %～ 80 %左右 ,4级分支显示 3 0 %～ 5 6%。有 3 0例 3 9支冠状动脉显示程度不同的狭窄 ,其中左主干病变 2支 ,左前降支及分支病变 2 0支 ,回旋支病变 9支 ,右冠状动脉病变 8支。VRT能够在三维立体空间内直观、形象、清楚地显示冠状动脉的形态分布走行情况以及在心脏表面的位置。CPR能显示各支冠状动脉从主动脉起始部到终末端的剖面情况 ,可清晰显示血管的最大直径内形态及管腔有无狭窄 ,以及狭窄段的长度。MPR以连续层面显示各支冠状动脉的节段性形态 ,可于监视器上以电影方式动态观察 ,可以获得冠状动脉各支的完整信息。MIP能显示冠状动脉各支类似于DSA血管的影像 ,可以显示钙化以及管腔形态。Objective To investigate the application of different reconstruction techniques in SIEMENS 16 multidetector spiral CT coronary angiography.Methods Multidetector spiral CT coronary angiographies were performed in 50 patients suspected coronary heart disease. Volumes rendering technique (VRT), multiplanar reconstruction (MPR), curved planar reconstruction (CPR), maximum intensity projection (MIP) were obtained to display coronary arteries.Results Coronary calcium score was analysed.19 cases showed small to severe calcification ;4 cases had soft plaque.The first and second subsegment branches could be shown 100%,the third could be shown 60%～80% , the fourth could be showed 30%～56%.30 cases had 39 branches with stenosis,two main branches of the left coronary, 20 left descending arteries and branch. 9 left circumflex arteries,8 right coronary artery . VRT could visualize the curse of coronary artery in three dimensions directly. CPR could delineate a coronary artery and display its whole curse in single two dimension profile, which was helpful for demonstrate the maximum diameter and whether there was stricture. MPR could display segments of coronary artery in one profile, and the whole reformation of each coronary artery could be obtained by dynamic observation on the monitory. MIP could show the coronary artery in a manner similarly to the DSA and display the calcification.Conclusion Combining the four reconstruction techniques can be demonstrated whether there is stenosis and the degree and length of coronary artery lesion. This information can be transported to the physician rapidly, which is helpful for the patient’s management.

关 键 词：冠状动脉造影 狭窄 钙化 多排螺旋CT 血管 CPR 重建技术 显示 分支 大直径 

分 类 号：R541.4[医药卫生—心血管疾病] R543[医药卫生—内科学]