320排CT在诊断冠状动脉病变的临床应用

The clinical application of 320-slice spiral CT in diagnosing coronary artery lesions

目的探讨320排CT对诊断冠状动脉病变的特点,以及冠心病危险因素与冠状动脉病变程度的关系。方法对我院2009年1月至2010年8月的233例胸痛患者行320排CT冠状动脉造影检查,对冠状动脉病变进行诊断。同时收集患者血脂、血糖、血压、体重指数、年龄、吸烟和心血管病家族史等危险因素,分析它们与冠状动脉病变程度的关系。另外,对其中的57例患者同时行选择性冠状动脉造影。结果发现191例患者呈右冠优势型,左冠优势型有11例,均衡型有31例。心肌桥61例,冠状动脉畸形3例。冠状动脉病变的有135例,1支血管病变的44例,2支血管病变的50例,3支血管病变的41例,无累及血管病变的98例。随着冠心病危险因素的增多,冠状动脉病变累及的血管支数、左主干受累、病变狭窄程度增加。57例320排CT冠状动脉造影显示冠状动脉病变的患者,经过选择性冠状动脉造影检查证实55例诊断为冠心病。结论 320排CT冠状动脉造影对冠状动脉病变的诊断是一种安全、可靠的非侵入性检查方法。随着冠心病危险因素的增加,冠状动脉病变程度加重。

Objective To investigate the clinical application of 320-slices spiral CT in diagnosing coronary artery lesions and the relationship of the risk factors of coronary artery disease and the severity of coronary artery lesions.Methods Two hundred and thirty-three cases with chest pain were performed 320-slices spiral CT for coronary artery from Jan 2009 to Aug 2010.The risk factors including sex,age,blood pressure,lipid,blood glucose,smoking,family history of coronary artery disease and body mass index were collected.We investigated the relationship between coronary lesions and risk factors.Fifty of the 233 patients underwent selective coronary artery angiography.Results The main branches and part of the sub-branches of the coronary artery were clearly displayed.Seventy cases of right coronary artery were dominant,eleven cases were coronary-balanced,and 3 cases of left coronary artery were dominant.1 cases of abnormality of coronary artery.Fifty cases were found coronary artery stenosis.Three vessels lesion,left main coronary artery and severe coronary artery occlusion in high risk group were significantly higher than those in low risk group.Thirty-six patients were diagnosed as coronary artery lesion by 320-slices spiral CT.But thirty-four patients were confirmed by coronary artery angiography.Conclusions As a minimally noninvasive examination,320-slices spiral CT is a valuable and safety method to detect and diagnose coronary artery diseases.The more risk factors were,the more serious the coronary artery stenosis and higher incidence of coronary heart disease.