右冠分叉病变三维重建最佳投照角度与介入投照角度的对照研究  

Comparative study for assessment of right coronary artery bifurcation lesions between optimal angle calculated by three-dimensional quantitative coronaryangiography and intervention angle

作　　者：周珊珊[1] 郝培远[1] 陈爱华[1] 宋旭东[1] 魏向龙[1] 何非[1] 涂圣贤 

机构地区：[1]南方医科大学珠江医院心内科 [2]Dpartment of Radiology,Leiden University Medical Center 22300 RC Leiden,the Netherlands

出　　处：《实用医学杂志》2011年第16期2943-2946,共4页The Journal of Practical Medicine

基　　金：广东省医学技术研究基金资助(编号:2008B030303019)

摘　　要：目的:研究medis3D系统快速生成的用于右冠状动脉分叉病变介入治疗的最佳投照角度的准确性。方法:随机抽取我院2009年5-11月期间接受右冠状动脉介入治疗的20位患者进行回顾性研究。通过患者右冠脉病变的两个视图的投照影像进行三维靶血管重建,快速生成最少短缩率或延长率的最佳投照角度,选取两名10年以上介入经验的术者对其优越性进行评估,量化为-2至2五个等级。并对短缩率和所需投照次数进行比较评估。结果:本研究20例右冠状动脉的三维重建率为100%。生成的最佳投射角度量化评分1.38±0.72,明显优于实际介入时的角度,P<0.01。最佳投照角度下右冠状动脉主支三维长度与实际介入角度下二维测量无明显差异(32.54±5.68mmvs29.43±5.47mm,P=0.72),侧支明显长于实际测量值(26.58±3.59mmvs18.03±5.12mm。P<0.05),而主、侧支短缩率均明显小于实际介入时的投照角度的短缩率(1.48±1.88vs10.54±4.89,P<0.01;3.6±2.35vs22.13±8.08,P<0.01),并能显著减少投照次数(2.10±0.31vs2.55±0.61)。结论:medis3D系统快速生成的用于冠状动脉介入治疗的最佳投照角度优于传统介入使用的投照角度,具有较少的短缩率,并能减少所需的X线投照次数。Objective This study was to determine whether the threedimensional （3D）reconstruction of traditional coronary angiography could optimize the projection angle to clearly show the right coronary bifurcation lesions. Methods Twenty patients underwent interventional stent-procedure in zhujiang hospital between May and November in 2009 were selected randomly. Cases and image data were reconstructed by medis 3D system from two coronary angiography views and the extend ratio was automatically calculated.The advantage and feasibility evaluation results were quantified into five score levels ranging from -2 to 2. Shorten ratio and projection number in optimal angle was compared with that in intervention angle and ideal intervention angle separately. Results The rate of 3D reconstruction achieves 100%, the score of optimal angle was significantly higher than actual intervention angle （mean score of optimal, 1.38 ± 0.72, P 〈 0.01 ）. Through the optimal angle, the length of main branch of right coronary was measured no significant difference as that through actual intervention angle （32.54 ± 5.68 mm vs 29.43 ± 5.47 mm,P = 0.72）, but the length of offshoot of right coronary was longer（26.58 ±3.59 mm vs 18.03 ± 5.12 mm. P 〈 0.05）. In optimal angle,the shorten ratio of right coronary and its offshoot was significantly less than that in actual intervention angle （1.48 ± 1.88 vs 10.54 ± 4.89, P 〈 0.01;3.6 ± 2.35 vs 22.13 ± 8.08,P 〈 0.01）, meanwhile, the projection number was significantly decreased（2.10 ± 0.31 vs 2.55 ± 0.61）. Conclusion Due to the shorten ratio and tess projection number needed, the optimal angle reconstructed by Medis 3D system was better than actual intervention angle.

关 键 词：右冠状动脉分叉病变 三维重建 介入 最佳投照角度 

分 类 号：R541.4[医药卫生—心血管疾病]