双源 CT评价冠状动脉狭窄与左心室功能的临床应用价值  

Clinical application of dual-source computed tomography angiography in evaluation of coronary artery stenosis and left ventricular function

作　　者：胡春峰[1] 徐凯[1] 袁莹莹[1] 汪秀玲[1] 李绍东[1] 程广军[1] 谢丽响[1] 

机构地区：[1]徐州医学院附属医院放射科,江苏徐州221002

出　　处：《实用放射学杂志》2012年第8期1192-1196,共5页Journal of Practical Radiology

摘　　要：探讨双源CT（dual-source computed tomography,DSCT）冠状动脉造影评价冠状动脉狭窄程度与左心功能的相关性。方法 收集行DSCT冠状动脉造影检查冠心病患者87例及30例健康体检者,测量冠状动脉狭窄程度、左室舒张末期容积（EDV）、左室收缩末期容积（ESV）、每搏输出量（SV）、射血分数（EF）、心肌质量（MM）,并与超声心动图（ECHO）、冠状动脉造影（CAG）作对照分析。结果 ①DSCT与CAG诊断冠状动脉狭窄无显著性差异（P〉0.05）。②DSCT和ECHO测量EDV、ESV、SV、EF相关性好,DSCT测得值稍大于ECHO,但各指标均无显著性差异（P〉0.05）。③ESV、EF、SV轻度狭窄组与重度狭窄组、中度狭窄与重度狭窄组间存在显著性差异（P〈0.05）,轻度狭窄组与中度狭窄组间无显著性差异（P〉0.05）;EDV、MM在轻度、中度、重度狭窄组间存在显著性差异（P〈0.05）;各指标在正常组和轻度狭窄组间无显著性差异（P〉0.05）。结论 DSCT冠状动脉造影一站式评估冠状动脉狭窄及心功能具有准确性高、可重复定量测量优势。根据冠状动脉狭窄程度可以初步评估心功能改变,当中度狭窄时,EDV、MM即出现显著改变,当重度狭窄时,各指标均出现显著改变,对心脏病变诊断、治疗监测等具有重要的临床应用价值。Objective To assess the correlation between the degree of coronary stenosis and left ventricular function using dualsource computed tomography{DSCT） coronary artery angiography. Methods The degree of coronary stenosis, left ventricular enddiastolic-volume（EDV） , left ventricular end-systolic-volume （ ESV ） , stroke-volume （SV） , ejection-fraction （EF） , and myocardial mass （MM） were retrospectively measured based on CT data in 87 patients who underwent DSCT coronary artery angiography （CAG） because of coronary artery disease and 30 healthy persons. The results of DSCT were compared with that of echocardiography（ECHO） and CAG. Results （1） In diagnosis of coronary artery stenosis, DSCT and CAG were of same ability. （2） There was better correlation in measurement of EDV, ESV, SV and EF with DSCT and ECHO, while the parameters measured with DSCT were slightly overestimated compared to ECHO. （3）ESV, EF, SV were significantly different between mild and severe stenosis groups, moderate and severe stenosis groups （P〈0.05）, but were no significantly different between mild and moderate stenosis groups（P〈0.05）. EDV, MM were significantly different among mild, moderate and severe stenosis groups（P〈0.05）. All parameters between normal and mild groups were not significantly different. Conclusion DSCT coronary artery angiography can one-stop evaluate the degree of coronary stenosis and left ventricular function accurately and reproducibly. According to the degree of coronary stenosis, left ventricular function can be evaluated. EDV and MM are significantly changed when coronary stenosis moderately, while all parameters are significantly changed when coronary stenosis severely, it is essential to the diagnosis, therapy guidance, and follow-up of coronary artery disease.

关 键 词：心脏 左心室 冠状动脉狭窄 体层摄影术 X线计算机 

分 类 号：R543.3[医药卫生—心血管疾病] R322.11[医药卫生—内科学]