冠心病肺部感染患者双源CT血管成像在诊断中的应用评价  

The application evaluation of dual-source CT angiography in diagnosing coronary heart disease with pulmonary infections

作　　者：朱丙烟[1] 付风魁[1] 朱荣广[1] 尹洪花[1] 陈斐[1] 

机构地区：[1]滨州市人民医院放射科,山东滨州256610

出　　处：《中华医院感染学杂志》2015年第14期3229-3231,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(ZR2009CL018)

摘　　要：目的探讨双源CT血管成像(CT angiographye,CTA)在冠心病(coronary heart disease,CHD)合并肺部感染患者中的诊断价值。方法收集2013年1月-2014年11月CHD合并肺部感染患者65例,均经冠状动脉造影术证实为CHD且均在双源CT行冠状动脉的CTA扫描,分析冠状动脉CTA的图像质量和血管的病变。结果所有患者均出现肺部感染的临床症状;CTA图像质量达到1级的46例占70.8%、2级的有11例占16.9%、3级7例占10.8%、4级1例占1.5%;148支主要血管出现不同程度狭窄,其中轻度狭窄的有8例占12.3%,21例呈中度狭窄占32.3%,36例呈重度狭窄占55.4%;26例以钙化斑块为主占40.0%,12例以脂斑为主占18.5%,27例以混合斑块为主占41.5%;24例以右心冠状动脉状动脉作为主病变血管占36.9%,39例以前降支作为主病变血管的占60.0%,2例以左回旋支作为主病变血管占3.1%。结论肺部感染可加重CHD的症状,双源CTA可明显降低肺部感染对图像质量和诊断的影响。OBJECTIVE To explore the clinical value of dual-source CT angiography（CTA）in diagnosing the coronary heart disease（CHD）with pulmonary infections.METHODS A total of 65 cases proven to have CHD with pulmonary infections from Jan.2011 to Nov.2014 were checked by Dual-source CT angiography and confirmed by coronary angiography.The image quality and vascular disease of CTA were analyzed.RESULTS All patients had lung infection symptoms.Image quality of 46 cases was level 1,which accounted for 70.8% of all cases.Split or blur wall of artery were found in 19 cases including 11 cases of level 2,7cases of level 3and 1case of level 4,accounting for 16.9%,10.8% and 1.5% respectively.Different degrees of blood stenosis were found in 148 major arteries.Mild stenosis,moderate stenosis and severe stenosis of artery were found in 8cases,21 cases and 36 cases respectively,accounting for 12.3%,32.3% and 55.4% of all the cases respectively.Calcified plaques were mainly found in 26 cases,accounting for 40%.Lipid plaques were mainly found in 12 cases,accounting for 8.5%,and mix plaque mainly found in 27 cases,accounting for 41.5%.Right coronary artery was the primary lesion in24 cases,accounting for 36.9%.Left anterior descending branch was the primary lesion in 39 cases,accounting for 60%.Left circumflex branch was the primary lesion in 2cases,accounting for 3.1%.CONCLUSIONPulmonary infection can aggravate the symptoms of CHD,and dual-source CTA can reduce the side effect caused by pulmonary infections on the image quality and diagnosis result.

关 键 词：冠心病 肺部感染 双源CT 

分 类 号：R563.1[医药卫生—呼吸系统]