摘要
目的评价16层螺旋CT对冠状动脉桥血管的显示能力。方法回顾性分析17例冠状动脉搭桥术(CABG)后患者的CT和选择性桥血管造影的资料,男15例,女2例,年龄51～78岁,平均(67±7)岁,术后6～85个月,平均(32±19)个月。共40支桥血管,原位乳内动脉13支,游离桡动脉11支,游离大隐静脉16支。由两位有丰富心血管影像诊断学经验的医生采用双盲法阅片,并取得一致结果。评价指标包括CT成像中桥血管的可评价性、有无闭塞或狭窄(管径缩小50%～99%)。结果所有40支桥血管均可评价,CT准确诊断5支桥血管闭塞和1支狭窄外,各有1例假阳性,其诊断桥血管闭塞与狭窄的敏感性、特异性达100%和97%,准确率分别为97.5%和97.1%。发生闭塞的血管与桥血管的类型和分布无关。结论16层螺旋CT是一种值得信赖的无创性随访研究桥血管通畅性的影像学方法。
Objective To investigate the detection ability of 16-slice CT in patients with coronary artery bypass grafts （CABG）. Methods A retrospective analysis of noninvasive coronary angiographies with multislice CT （MSCT） and invasive CABG angiographies in 17 patients .（15 male and 2 female, mean age, 67±7 years） was conducted. The duration from bypass surgery to MSCT scanning was 6 to 85 months with mean duration of （32±19） months. There were 40 grafts including 13 internal mammary arteries, 11 free radial arteries and 16 free saphenous vein grafts. MSCT images and invasive anglograms were blinded analyzed by two experienced radiologists, respectively. And consensus was reached. The evaluability, occlusion and 50%-99% stenosis of CABG on CT images were compared with the golden standard of invasive angiography. Results All 40 grafts were evaluable and 5 occluded grafts and 1 stenosis were correctly classified by MSCT. But one false occlusion and one false stenosis were also found. The sensitivity and specificity for CABG occlusion and stenosis were 100% and 97%. The diagnostic accuracy was 97.5% and 97.1% for CABG occlusion and stenosis, respectively. There was no correlation between the occluded grafts and its source as well as the native coronary connected with it. Conclusion 16-slice CT is a reliable noninvasive follow-up method for the evaluation of bypass graft patency or stenosis.
出处
《中国医学影像技术》
CSCD
北大核心
2006年第3期380-383,共4页
Chinese Journal of Medical Imaging Technology
