冠状动脉16层螺旋CT成像技术特点及临床应用  

Imaging Technique and Clinical Application of 16-slice Spiral CT for Coronary Artery

作　　者：杨志刚[1] 卢春燕[1] 余建群[1] 李真林[1] 朱捷[1] 孙家瑜[1] 帅丹丹[1] 

机构地区：[1]四川大学华西医院放射科,成都610041

出　　处：《生物医学工程学杂志》2005年第5期930-934,共5页Journal of Biomedical Engineering

摘　　要：通过对38例临床怀疑冠心病的患者进行16层螺旋CT(Spiral computed tomography,SCT)心电门控平扫及增强扫描,探讨16层SCT冠脉的成像技术特点及其初步临床应用价值。对所有病例的舒张期增强扫描图像行多平面重建(Multiple planar reconstruction,MPR)、最大密度投影(Maximum intensity projection,MIP)及容积再现(Volume rendering technique,VRT),并根据需要行曲面重组(Curved planar reformat,CPR)及仿真内窥镜(Virtual endoscopy VE)重建。总结16层SCT冠脉成像的显示情况,分析影响冠脉成像的因素。结果表明,38例中,右冠脉、后降支、左冠脉主干、左前降支、对角支、左回旋支及左缘支横断面图像的显示率分别为94.7%、89.5%、97.4%、94.7%、94.4%、94.7%及89.5%,明显高于3D图像(MIP和VRT)的显示率(P<0.01)。所以16层SCT冠脉横断面图像与3D重建图像能准确地显示冠脉主干及其主要分支的走行及异常,是一种无创性的冠脉疾病筛选、诊断及术后评价的检查方法。影响冠脉图像质量的因素主要有心率、心律、呼吸运动以及重建相位窗等。This study was conducted in pursuit of the optimal imaging technique and for a primary clinical application of 16-slice muitisiice spiral computed tomography （MSCT） for coronary artery. Onenhanced and contrast-enhanced 16-slice SCT imaging was performed in 38 cases with retrospective electrocardiographic gating. MPR, MIP and VRT reconstruction of enhanced scan images were made in all cases, and CPR, VE reconstruction images were made in some cases. The demonstration of coronary artery was evaluated. The influencing factors of the image quality were analyzed. The results showed that the detection rates of RCA, PDA, LMA, LAD, DB, LCX and LMB were 36（94.7%）, 34（89.5%）, 37（97.4%）, 36（94.7%）, 34（94.4% ）, 36（94.7%）, 34（89.5%0） on axial images, respectively, which were higher than those of the arteries on 3D images （P〈0.01）. Therefore, 16-slice spiral CT is a reliable and accurate technique to demonstrate coronary artery and its branches, and is a noninvasive method to screen, diagnose and postoperatively evaluate coronary artery diseases. The factors influencing the image quality include the heart rate, the cardiac rhythm, the respiratory movement of patients and the trigger delays of imaging processing.

关 键 词：冠状动脉 16层 体层摄影术 X线计算机 螺旋CT成像技术 临床应用价值 冠状动脉 ENDOSCOPY 左冠脉主干 横断面图像 最大密度投影 扫描图像 多平面重建 

分 类 号：R816.2[医药卫生—放射医学]