64层螺旋CT冠状动脉成像的临床应用  

The clinical application of 64-slice computed tomography coronary angiography

作　　者：臧任丽[1,2] 高国政[2] 姜兴岳[1] 

机构地区：[1]滨州医学院附属医院放射科,滨州256603 [2]滨州市中心医院影像中心

出　　处：《滨州医学院学报》2014年第2期122-125,121,共5页Journal of Binzhou Medical University

摘　　要：目的综合文献回顾评价目前64层螺旋CT冠状动脉成像的临床应用价值。方法 2011年3月至2013年3月96例病人行64层螺旋CT冠状动脉成像,剔除12例图像不可评价的病人,其中51例病人同时行导管法冠状动脉造影,其中冠状动脉支架置入术后复查者11例,冠状动脉搭桥术后复查者3例,以DSA结果作为标准对比分析,计算MSCTCA检出冠状动脉狭窄的准确率和阴性预测值,结合文献报道分析其对冠状动脉支架置入术后、搭桥术后疗效的评估价值。结果和DSA比较,MSCT对各支冠状动脉病变检出能力不同,以左主干最高、其次是右冠状动脉及左前降支,对回旋支检出率略低,但阴性预测值较高。18个支架及6支桥血管均清晰显示,检出支架轻微变形者3个、狭窄者4个;6支桥血管显示血流情况良好,与DSA结果基本吻合。结论 MSCT对冠状动脉狭窄的诊断准确率较高,对冠状动脉支架及桥血管显示直观准确,所以可作为疑诊冠心病者行常规冠状动脉造影检查前的筛查手段和冠状动脉支架置入术后、冠状动脉搭桥术后的评估手段。Objective Comprehensive literature review to evaluate the current the clinical value of 64-slice spiral CT coronary artery imaging .Methods 96 patients were undergone 64-slice CTCA period from March 2011 to March 2013 ,12 cases whose images not evaluated were eliminated ,51 cases were undergone selective coronary angiography at the same time .In these 51 pa-tients ,11 patients had be done coronary stent placement ,and 3 cases had be done coronary artery bypass grafts .To calculate the results of MSCTA and DSA detection of coronary artery stenosis degree of accuracy and negative predictive value ,According to the literature to analyze the evaluation values with coronary artery stent palcement or coronary artery bypass grafts .Results Compared with DSA ,there is obvious difference in the ability of MSCT detecting each different branch of coronary artery le-sion ,among them LM was the highest ,then was RCA and LAD ,detection of LX was slightly lower ,but the negative predic-tive value was mostly high .18 stents blood vessels and 6 bridge vessels are clear display .check out the stent in slight deforma-tion of 3 ,stenosis of 4;Six bridge vessels showed in good condition ,was consistent with the results of DSA .Conclusion MSCT in diagnosis of coronary artery stenosis accuracy is higher ,it can detect the coronary artery stents and bridge vessels vis-ually and accurately ,and so can be used as a history of coronary heart disease is a line of conventional coronary angiography ex-amination before the screening and after coronary artery stent ,assessment methods after coronary artery bypass surgery .

关 键 词：冠状动脉血管造影术 冠状动脉疾病 体层摄影术 X线计算机 

分 类 号：R816.2[医药卫生—放射医学]