320排容积CT低剂量冠状动脉成像在冠心病高危人群中的应用  

Application of 320-slice volume CT with low-dose in high-risk groups with coronary artery disease

作　　者：潘宇宁[1] 黄求理[1] 叶贤旺[1] 张杰[1] 廉艳东[1] 傅芬芬[1] 

机构地区：[1]宁波市第一医院医学影像科,浙江宁波315010

出　　处：《实用放射学杂志》2011年第8期1161-1164,共4页Journal of Practical Radiology

摘　　要：目的探讨320排容积CT冠状动脉造影（VCTA）在冠心病高危人群中的应用价值。方法对近期300例有冠心病高危因素的患者，应用320排动态容积CT前瞻性心电门控全心容积扫描检查，其中43例有冠状动脉造影作为对照，并对本组所有显示的冠状动脉主干及其主要分支进行分级评价，对所有病例进行辐射剂量统计。结果本组300例发现病变163例，单支病变112例，多支病变51例；其中狭窄度≥70％59例（36．2％），〈70％104例（63．8％）。320排容积CT冠状动脉成像诊断≥70％冠状动脉狭窄的敏感性、特异性、阳性预测值、阴性预测值分别为96．6％，97．9％，92．3％，99．1％。冠状动脉成像质量1级256例（85．3％），2级41例（13．7％），3级3例（1．0％）。使用的平均有效剂量为（3．06±0．30）mSv。结论320排动态容积CT冠状动脉成像速度快，诊断冠状动脉狭窄准确性高，图像质量好，辐射剂量低，是冠心病高危人群筛查的首选检查。Objective To investigate the applied value of 320-slice volume CT angiography（VCTA） in high-risk groups with coronary artery disease（CAD）. Methods 300 patients with a high pre-test probability population of CAD underwent 320-slice ECG gating volume CT scanning. Of them, forty-three patients underwend coronary angiography（CAG）. The branches of coronary arteries showed by VCTA were evaluated in branching comparatively both VCTA and CAG. And the radiation dose was statistically evaluated. Results Among the 300 patients,163 cases with CAD were found,including single vessel diseases in 112 cases, multi-vessel disease in 51 cases;the arterial stenosis ≥70% in 59 cases（36.2%）, 〈 70% in 104 cases （ 63.8% ） . The sensitivity,specificity , positive predictive value and negative predictive value of VCTA in detection of hemodynamically relevant stenoses（ ≥70M ） were 96.6% ,97.9% ,92.3% and 99.1% ,respectively. The image quality was up to first class in 256 patients（85.3% ） ,second class in 41 patients（13.7%）and third class in 3 cases（1.0%）. The effective radiation dose （ED） was （3.06±0.39） mSv. Conclusion 320-slice VCTA is the first choice in high pre-test probability population with CAD because of speed, high-diagnostic value, good image quality and low radiation dose.

关 键 词：心脏 冠心病 体层摄影术 X线计算机 

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