16层螺旋CT冠状动脉成像初步探讨  

Initial experiences about 16-detector row CT coronary angiography

作　　者：朱海峰[1] 范家栋[2] 郑卓肇[2] 何汇忱[1] 舒邦明[3] 

机构地区：[1]民航总医院放射科,北京100025 [2]北京大学第三医院放射科 [3]民航总医院心内科,北京100025

出　　处：《中华放射学杂志》2006年第10期1064-1068,共5页Chinese Journal of Radiology

摘　　要：目的探讨心率与多层螺旋 CT(MSCT)冠状动脉(简称冠脉)成像运动伪影的关系,及MSCT 冠脉成像的临床应用价值。方法对200例临床拟诊冠心病的患者行 MSCT 冠脉成像检查,分析扫描时心率与冠脉运动伪影的关系;其中37例同时行常规冠脉造影(简称冠造)检查,对比分析2种检查结果。结果扫描时心率≤55次/min、56～60次/min、61～65次/min、66～70次/min和>70次/min 组有运动伪影的冠脉节段分别占冠脉总数的0.1%(1/759)、1.1%(7/649)、2.5%(10/407)、42.6%(103/242)和75.5%(108/143);以常规冠造作为金标准,MSCT 诊断狭窄≥50%的敏感度、特异度、阳性预测值、阴性预测值分别为79.2%、96.0%、83.8%、94.6%。扫描时心率与冠脉运动伪影的数量显著相关(r=0.655,P=0.000)。结论 MSCT 能较准确诊断冠脉50%以上的狭窄,是无创性诊断冠脉狭窄的重要工具。Objective To investigate the influence of a patient＇s heart rate on the presence of motion artifacts and on accuracy of stenosis detection on contrast-enhanced MSCT. Methods Two hundred patients with suspected coronary artery disease underwent the contrast-enhance MSCT, the main factors influencing imaging quality were analyzed. Thirty-seven patients underwent conventional selective coronary angiography in the same time. The results obtained from MSCT were compared. Results In the 5 groups （heart rate≤55 bpm, 56--60 bpm, 61--65 bpm, 66--70 bpm, 〉70 bpm during scan） , the proportion of segments that could not be assessed because of motion artifact were 0. 1% （1/759） , 1, 1% （7/649）, 2, 5% （ 10/407 ） , 42. 6% （ 103/242 ）, and 75.5% （ 108/143 ） , respectively. With conventional selective coronary angiography as the golden standard, the sensitivity, specificity, positive and negative prediction values to detect 〉150% stenotic lesions in the assessable segments were 79. 2% , 96. 0% , 83.8% , and 94. 6% , respectively. There was a significant correlation between the number of segments per patient not assessable because of motion artifact and heart rate during the scan （ r = 0. 655, P = 0. 000 ）. Conclusion MSCT is capable of achieving high accuracy for detection of coronary artery stenosis, and is a reliable technique to diagnose coronary artery disease.

关 键 词：冠状动脉疾病 体层摄影术 X线计算机 心血管造影术 

分 类 号：R816.2[医药卫生—放射医学]