摘要
目的:评价16排CT冠状动脉造影在冠状动脉疾病诊断中的价值。方法:本组706例受检者行16排螺旋CT冠状动脉血管造影成像检查,其中537例受检者给予常规剂量β受体阻滞剂,控制心率在65±10次/分,采用后置性心电门控电影扫描序列进行扫描,层厚为1.25mm,螺距为0.275:1,非离子型造影剂1.5-2mm/Kg,碘浓度为300mgI/ml或370mgI/ml,注射速率3-4ml/s,在注射造影剂后,屏气20秒左右,显示冠状动脉主干及其属支(左冠状动脉主干、左前降支、左回旋支以及右冠状动脉)并对其进行评价。后处理采用容积再现(VR)、最大密度投影(MIP)、多平面重建(MPR)、曲面重建(CPR)以及仿真内窥镜(VE)。结果:706例受检者有2556根冠状动脉被评价,其敏感性、特异性、准确性、阳性预测值、阴性预测值分别是96%、88%、89%、91%、93%。检测有意义的狭窄(≥50%的狭窄)936/2556(36.92%)根,其中钙化性狭窄773/936(82.59%),非钙化性斑块狭窄163/936(17.50%),单根血管有意义的狭窄为612/936(65.38%),两根血管有意义的狭窄为237/936(22.32%),三根以上血管有意义的狭窄为113/936(12.07%)。4、结论:如果控制好心率和改善扫描技术,16排CT冠状动脉血管造影能较为满意地显示冠状动脉主干及其属支,对冠心病的筛查、血管搭桥以及内支架置入后疗效随访均有较大的临床应用价值。
Objective： To evaluate the coronary artery with 16 detector CT coronary angiography. Method： In 706 patients, 16 detector CT was performed and ECG - gated cross - sectional imaging were retrospectively reconstructed. 537 patients were given additional β - blockers. Avereage heart rate was 65 ± 10 beats/min. We reconstructed cross - sectional images with a slice thickness of 1.25 mm with spiral picth 0.275： 1. Contrast media of 100 to 120 ml （1.5 - 2.0ml/kg） was injected intravenously at speed of 3 -4ml/s. The reconstructed images were then processed into Volume Rendering （VR）, Multiplanner Reconstruction （MPR）, Curved Planner Reconstruction （CPR）, Maximum Intensity Projection （MIP）, and Virtual Endoscopy （VE） . Main coronary artery and coronary artery branches （the left main coronary artery, the left anterior descending coronary artery, the left circumflex coronary artery, and the fight coronary artery） were evaluated, respectively. Results： 706 patients （2556 coronary arterial branches） were evaluated. In 2556 branches, sensitive, specificity, accuracy, positive predictive value, and negative predictive value with multidetector CT angiography were 96%, 88%, 89%, 91%, 93%, respectivesly. 936/2556 （36.92 % ） evaluated branches were significantly diseased for ≥ 50 % stenoses, including calcified stenoses 773/936 （82.59 % ） branches, noncalcified plaque stenoses 163/936 （17.50） branches, single branches significant stenoses 612/936 （65.38 % ）, two branches significant stenoses 237/936 （22.32%）, more than three branches vessels significant stenoses 113/936 （12.07%） . Conclusion： Under improvements in technology, combined with heart rate control, 16MDCT coronary angiography can reveal main coronal arteries and branches. There are high clinical useful value in screening coronary heart diseases and following up coronatal arterial graft and stent.
出处
《福州总医院学报》
2008年第3期191-193,238,共4页
Journal of Fuzhou General Hospital
关键词
心脏
冠状动脉
多层CT
heart
coronary artery
16 - multidetector CT
