16层螺旋CT冠状动脉成像的临床应用  

Clinical application of 16-slice spiral CT coronary angiography

作　　者：罗云辉[1] 彭秀斌[1] 毛俊[1] 孙放[1] 肖万宏[1] 刘玉涛[1] 陈海东[1] 林丽娟[1] 龙雪银[1] 

机构地区：[1]暨南大学附属第三医院影像科,广东珠海519000

出　　处：《中国中西医结合影像学杂志》2007年第5期338-341,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:探讨16层螺旋CT冠状动脉(简称冠脉)成像在冠心病诊断中的临床价值。方法:选取50例临床诊断或可疑冠心病患者行16层螺旋CT冠状动脉造影检查(MSCTCA),先行冠脉钙化积分平扫,然后行冠脉增强扫描,选取一组质量最佳的薄层图像行冠脉三维重建,分析MSCTCA对冠状动脉狭窄性病变的显示能力,并对冠脉支架显示及通畅性进行评价。结果:冠脉钙化积分与其狭窄程度呈正相关,中度以上狭窄的冠脉钙化积分值明显高于轻度狭窄,其间有统计学显著性差异(P<0.001)。MSCTCA对诊断有临床意义的冠脉中度以上狭窄的敏感度、特异度、诊断准确率、阳性预测值、阴性预测值分别约89.6%、93.9%、92.6%、86.7%、95.4%。MSCTCA对冠脉支架显示良好,检出5例9根支架,其中2根支架不通畅,出现支架内再狭窄。结论:16层螺旋CT冠脉成像安全、无创,对评价冠状动脉狭窄、支架开放及通畅性等方面有着较高的临床应用价值,可作为冠心病筛查的有效手段以及介入和手术治疗后的随访手段。Objective：To evaluate the clinical value of 16-slice spiral CT coronary angiography （MSCTCA） in diagnosis of coronary heart diseases （CHD）. Methods： Fifty patients, which were clinically diagnosed or suspected CHD, were studied by 16-slice MSCTCA. The coronary artery （CA） calcification scores was first performed, then enhanced CA scanning done. The one group of the best quality of thin-thickness constructed images was selected to perform 3-dimensional CA process. The ability to display CA stenosis by MSCTCA was analysed, and the displaying of CA stent and its patency was evaluated. Results： CA calcification scores was positive related to CA stenosis degree. The CA calcification score value of above moderate-degree stenosis was obviously higher than mild-degree stenosis. There were statistically significant differences among them （ P〈0. 001）. The sensitivity, specificity, accuracy, positive predicted value and negative predicted value of MSCTCA in detection of clinically significant stenosis （≥50%） were about 89.6%, 93.9%, 92.6%, 86.7% ,95.4% respectively. The CA stent was displayed well in MSCTCA;9 stents in 5 patients were detected, and 2 stents of them were not lucid （inside-stent stenosis again）. Conclusion： 16-slice spiral CT coronary angiography is a safe, noninvasive tool, and is valuable in clinical application for evaluating CA stenosis and stent patency. It can be used as efficient means of CHD screening, as well as follow-up of CHD intervention and surgical operation treatment after.

关 键 词：体层摄影术 X线计算机 冠状动脉血管成像 冠心病 

分 类 号：R816.2[医药卫生—放射医学]