多层螺旋CT冠状动脉造影对血管内支架形态变化的研究  

Evaluation of Multi-slice Spiral CT Coronary Artery Angiography in Endovascular Stent Deformation

作　　者：温智勇[1] 齐旭红[1] 任冰[1] 康枫[1] 

机构地区：[1]北京电力医院放射科,100073

出　　处：《临床放射学杂志》2009年第2期198-200,共3页Journal of Clinical Radiology

摘　　要：目的探讨多层螺旋CT冠状动脉造影在观察冠状动脉内支架形态改变中的作用和意义。资料与方法采用GE Light speed 64排螺旋CT对冠状动脉进行造影检查。回顾性分析167例共417个冠状动脉内支架的CT冠状动脉造影检查结果。其中男131例,女36例,年龄43～82岁,平均56.02岁。结果417个支架中,共有145个(占34.8%)支架发生了不同形态变化。其中发生在左冠状动脉主干3个,前降支64个,回旋支30个,第一对角支3个,中间支2个,钝缘支2个;右冠状动脉主干31个,后降支10个。将145个变形支架分为4种类型:(1)局限性外压型40个,占27.6%;(2)非局限外压型64个,占44.1%;(3)支架叠加变形39个,占26.9%;(4)打开不全型2个,占1.4%。由于支架变形导致管腔狭窄,狭窄程度一般在25%～95%,平均65.47%(s=21.33)。结论64排螺旋CT冠状动脉造影是观察血管内支架形态变化和由此造成管腔狭窄的非常有效的方法,更有利于支架置入术后的随访观察。同时也为临床医师在术前对患者适应证的选择上和在术中对支架类型的选择上提供帮助。Objective The purpose of this study was to assess the clinical value of Multi-slice spiral CT coronary angiography （MSCTCA） in coronary artery stents deformation. Materials and Methods CT coronary angiography was performed on a 64-MDCT of GE light speed scanner. 167 patients with 417 coronary artery stents were analyzed in this study （ 131 male and 36 female;mean age 56.02 and variated from 43 to 82）. Results Of 417 coronary artery stents, 145 had different shape deformation （34.8%） ,3 at left main artery （LMA） ,64 at left anterior descending artery （LAD） ,30 at left circumflex artery （LCX） ,3 at first diagonal branch,2 at middle branch,2 at obtuse marginal branch （OM） ,31 at right coronary, artery （RCA） and 10 at posterior descending artery（PDA）. 145 coronary artery stents were divided into four groups ：40 were in limited extrapressure group （27.59%） ,64 were in non-limited extra-pressure group（44.14% ） ,39 were in superimposed deformation group （26.90%）, and 2 were in dilated insufficient group （1.38%）. The deformation of coronary artery stents caused restenosis which were usually between 25% and 95% and the mean was 65.47% （SD = 21.33）. Conclusion The 64-slice spiral CT coronary angiography is clinically useful for assessing deformation of endovascular stent and for detecting in-stent restenosis. This suggests that MSCTCA could help doctors to select the appropriate patients and stent type.

关 键 词：体层摄影术 X线计算机 冠状动脉造影术 支架 变形 

分 类 号：R816.2[医药卫生—放射医学]