64层螺旋CT冠状动脉成像对冠心病诊断价值  

The Value of Diagnosis of Coronary Heart Disease with 64--slice Spiral CT Coronary Angiography

作　　者：史恒峰[1] 吴发银[1] 宋芹霞[1] 桂广华[1] 陈平[1] 熊小玲[1] 

机构地区：[1]安徽医科大学附属安庆医院CT中心,安徽安庆246003

出　　处：《实用放射学杂志》2010年第12期1739-1741,共3页Journal of Practical Radiology

摘　　要：目的 分析64层螺旋CT冠状动脉造影在冠心病诊断中的价值及不足.方法 对380例临床怀疑冠心病患者行64层螺旋CT冠状动脉造影（multi-slice spiral CT coronary angiography,MSCTA）,利用机器先进的后处理软件对血管进行评估并作出诊断.其中90例诊断不同程度狭窄的患者行数字减影冠状动脉造影（DSA）,并以此为金标准,比较MSCTA对冠状动脉病变的诊断一致性（未行冠状动脉造影的,只是用于评价64层螺旋CT对冠状动脉各支的显示能力,未涉及有无冠状动脉狭窄的评估）.结果 64层螺旋CT显示左、右冠状动脉1～2级分支,显示率为100% 3级分支显示率为87% 4级分支显示率为51%.90例行冠状动脉造影的患者显示158处不同程度狭窄,其中＜50%狭窄 MSCTA检出诊断一致率为86.7%,≥50%狭窄 MSCTA检出诊断一致率为93.8%.结论 MSCTA是一种安全、可靠和无创的影像学技术,可作为诊断冠心病及介入治疗前预案制订的首选方法.Objective To analyse the value and deficiencies of 64--slice spiral CT coronary angiography in diagnosis of coronary heart disease （CHD}. Methods 380 patients with clinically suspected or confirmed CHD were examined with 64--slice spiral CT coronary angiography （MSCTA）, in which, 90 patients were diagnosed with varying degrees of stenosis of coronary artery by DSA, which as gold standard,the consistency in diagnosis of CHD between DSA and MSCTA（if no coronary angiography, to evaluate the displaying capabilities of the various branches of the coronary with 64--slice spiral CT only, not including the assessment of coronary stenosis）. Results MSCTA could clearly show the right and left coronary artery branches of 1~2{ 100~ ） ,the showing rates for 3 th and 4 th branch were 870/00 and 51% ,respectively. 90 cases underwent routine coronary angiography,the stenosis of coronary arteriae in varying degrees was detected in 158 branches,of which, the degree of stenosis〈50 % was 86.7%, ≥50 % was 93.8%. Conclusion MSCTA is a safe, reliable and non--invasive imaging techniques, it can be used as diagnostic CHD.

关 键 词：心脏 体层摄影术 X线计算机 冠心病 心血管造影术 

分 类 号：R541.4[医药卫生—心血管疾病] R814.42[医药卫生—内科学]