MSCTA在评价冠状动脉旁路血管中的价值  

Evaluation of the value of coronary artery bypass grafts using multislice spiral CT angiograpyhy

作　　者：殷焱[1] 陈洁[1] 柴伟明[1] 华佳[1] 许建荣[1] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科,上海200127

出　　处：《医学影像学杂志》2008年第3期249-252,共4页Journal of Medical Imaging

摘　　要：目的:探讨利用多排螺旋CT技术评估冠状动脉旁路血管情况的临床应用价值。方法:选择42例冠状动脉旁路移植术后患者,对113条旁路血管(其中内乳动脉桥42条,隐静脉桥71条)分别用16排螺旋CT进行血管造影和常规冠状动脉造影进行检查。MSCTA检查均通过回顾性心电门控方法进行。然后进行原始薄层图像分别进行MPR、CPR及VR重建,冠状动脉桥血管的通畅和狭窄程度由3位有经验的放射科医师来评估。结果:MSCTA能显示绝大部分冠状动脉桥血管,经MSCTA检查发现有28条桥血管发生闭塞,10条桥血管有显著狭窄病变。通过CAG检查比较MSCTA结果证实:在所有38条MSCTA检查发现闭塞或狭窄的冠状动脉桥血管中,CAG显示有35条桥血管有闭塞或狭窄;在所有72条MSCTA检查显示正常的冠状动脉桥血管中,CAG显示有78条桥血管正常,总共有5例假阳性和2例假阴性发生。MSCTA检查的敏感性94.6%,特异性94%;阳性预测值87.5%,阴性预测值94%,Kappa指数0.87。结论:选择合适的冠状动脉旁路移植术后患者进行MSCTA冠状动脉旁路血管成像,可提供较为清晰的血管影像以及较高的诊断准确性。MSCTA可作为评估冠状动脉旁路血管病变的一种无创检查方法。Objective：To study the value of MSCTA in the evaluation of coronary artery bypass grafts.Methods：42 consecutive patients undergoing coronary artery bypass grafting were examined by computed tomography with 16 rows detector CT and by conventional coronary angiography.All CT scans were performed by retrospective ECG gating method.Then,the coronary artery bypass grafts were evaluated by 3 experienced readers.Results：In this research,the MSCTA can show the overwhelming majority coronary artery bypass grafts.28 occlusions and 10 stenoses of coronary artery bypass grafts were detected by MSCTA.The comparison of the results between MSCTA and CAG showed that there were 2 false negative and 5 false positive findings,resulting in a sensitivity of 94.6%,a specificity of 94%,a positive predictive value of 87.5%,and a negative predictive value of 94%.Conclusion：As a noninvasive examination,MSCTA is a valuable method to detect the lesions of coronary artery bypass grafts.

关 键 词：冠状动脉旁路血管 体层摄影术 X线计算机 血管造影术 冠状动脉分流术 

分 类 号：R543.3[医药卫生—心血管疾病] R814.42[医药卫生—内科学]