双源CT冠状动脉成像评估主动脉瓣形态结构及运动情况  

Evaluation of morphologic characteristics and changes of motion of the aortic valve with dual-source CT coronary angiography

作　　者：王朴飞[1] 吕梁[1] 王罡[1] 李治[1] 余波[1] 安鸿飞[1] 吴海燕[1] 

机构地区：[1]云南省第一人民医院放射科,云南昆明650032

出　　处：《实用放射学杂志》2014年第11期1822-1826,共5页Journal of Practical Radiology

摘　　要：目的探讨双源CT（DSCT）冠状动脉成像评估主动脉瓣形态及运动的可行性及准确性。方法125例临床拟诊冠状动脉病变患者行CT冠状动脉成像及经胸心脏超声（TTE）检查。间隔5％R—R间期重建0％～95％R—R间期20组数据。电影模式动态观察一次完整心动周期中各期相上主动脉瓣形态、开放及关闭情况，以及图像质量。采用方差分析比较收缩期各期相上主动脉瓣口面积（AVA）。结果125例患者共2500期图像中，92．3％图像为可评估图像；DSCT显示123例三瓣型主动脉瓣，二瓣畸型2例；主动脉瓣退行性改变27例，主动脉瓣瓣叶关闭不全26例，与TTE对照，存在3例假阳性，假阴性2例；92％主动脉瓣在0％～35％期相上呈开放状态，75．2％在40％～95％期相上呈关闭状态；收缩期各期相上AVA存在统计学差异（F=2．97，P〈0．05）。结论DSCT可在完整心动周期中准确、动态显示主动脉瓣形态及运动情况，在收缩期中期主动脉瓣图像质量最佳，且AVA最大。Objective To explore the feasibility and accuracy of dual-source computed tomography（DSCT） coronary angiography for evaluation the morphology and motion of aortic valve. Methods A total of 125 cases with suspected coronary artery disease underwent computed tomography coronary angiography and transthoracic echocardiograpby examination. Twenty CT data sets were reconstructed in 5% steps from 0% to 95% of R-R interval. The morphologic features, changes of motion and image quality of the aortic valve in cardiac cycle were observed and recorded with CT dynamic cine-mode technique. The differences of aortic opening area in the various phases of the systole were analyzed by using ANOVA. Results 92.3% of aortic valve images among the total 2500 phases were good enough for evaluated in the 125 patients examined. DSCT visualized 123 patients with tricuspid aortic valve while 2 patients with bicuspid aortic valve. 27 patients with degenerative aortic valve disease were identified. CT correctly identified 26 patients with aortic insufficiency during diastole. Compared with TTE, 3 patients were false positives and two patients were false negatives on DSCT. Aortic valve opening was seen in phase 0% to 35% in 92% of patients,and it was closed during phase 40% to 95% of R-R interval in 75.2% of patients. There were significant difference between the AVA in the various phases of the systole（F=2.97,P〈0.05）. Conclusion DSCT allows accurate and dynamic visualization of morphology and motion of aortic valve throughout the cardiac cycle. The area of the aortic opening is widest and image quality is best during midsystole.

关 键 词：主动脉瓣 计算机体层成像 超声心动描记术 

分 类 号：R322.121[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]