超高速CT在心血管病诊断中的应用

Ultrafast CT: clinical application in diagnosis of cardiovascular diseases

目的：评价超高速ＣＴ（ＵＦＣＴ）在心血管病诊断中的价值。材料与方法：对２０６９例心血管病患者进行超高速ＣＴ检查。其中平扫１８６２次，单层增强２７９次，电影序列１１０１次，血流序列２９５次，连续容积扫描８２次。结果：疑诊冠心病１７９２例，其中平扫发现冠状动脉钙化７０７例（３９％），其诊断冠心病的敏感性为７７％，特异性为８０％。其他包括瓣膜病７９例，心肌病３０例，心包疾患２５例，心脏肿瘤１１例，大血管疾患９７例，先天性心脏病２５例，肺动脉血栓栓塞１０例。结论：ＵＦＣＴ扫描可得到高分辨率的心脏大血管解剖影像，并可以评价心脏功能、器官灌注和血液动力学资料，在心血管病理上可以得到更详尽的。

Purpose: To evaluate the clinical application of ultrafast CT (UFCT) in diagnosis of cardiovascular diseases. Materials and methods: UFCT was achieved in 2 069 patients with various cardiovascular diseases, age ranged from 1 to 82 years. The scanning protocols included single slicee mode (SSM) with slice thickness 1.5, 3.0, 6.0, 10.0 mm, multislice mode (MSM) including cine study and flow study, and continuous volume scan (CVS). In this series of 2 069 cases, there were nonenhancement scans 1 862, contrast enhancement SSM 279, cine study 1 101, flow study 295, and CVS 82. The ECG triggering was used in SSM and MSM. Contrast media were injected by power injector. Results: Among the 2 069 patients with cardiovascular diseases the UFCT technical successful rate was 100%. In the group of the 1 792 patients suspected of coronary heart disease, coronary calcification was detected in 707 (39%). Of 1 792 patients, 90 cases underwent both UFCT and coronary arteriography. The sensitivity and specificity of calcification for diagnosis of coronary stenosis (>50%) were 77% and 80% respectively. Other cardiovascular diseases included valvular diseases in 79 cases, cardiomyopathy in 30, pericardial lesions in 25, cardiac tumors in 11, great vessel diseases in 97, congenital heart diseases in 25 and pulmonary thrombosis and embolism in 10 cases. Conclusion: With scan time as fast as 50～100 millisecond, UFCT can provide high resolution anatomical images of the heart and great vessels without motion artifacts. Both cine and flow studies can assess cardiac function, organ perfusion, and hemodynamics, allowing examination of cardiovascualr pathology in sharp detail for more accurate diagnosis.