多层螺旋CT仿真内镜在冠状动脉检查中的应用

Multislice spiral CT virtual endoscopy in coronary artery examination

目的:评价多层螺旋CT仿真内镜对冠状动脉内腔结构的显示能力,探讨其临床应用价值。方法:对108例接受多层螺旋CT冠状动脉造影及传统的冠状动脉造影检查的住院患者进行了仿真内镜重建。重建冠状动脉756支。结果:(1)756支冠状动脉中568支冠状动脉获得了满意的仿真内镜图像,成功率75%。(2)88处冠状动脉狭窄仿真内镜检出76处,检出率86%。(3)24例冠状动脉支架、4例移植血管及8例冠状动脉瘘均被检出。结论:多层螺旋CT仿真内镜能够显示大多数病例冠状动脉内腔结构,不失为一种无创性的、简便、低廉的可用于冠状动脉腔内检查的手段,尤其在冠状动脉钙化严重及畸形的病例起到重要的作用。

Objective: To evaluate the feasibility of reconstructing multislice spiral computed tomography virtual endoscopy (VE) and determine the clinical value of VE in detecting coronary artery lesions. Methods: Totally 108 in-patients underwent MSCT angiography. VEs were simulated in 756 coronary arteries (left main, left anterior descending, left circumflex and right coronary arteries and their branches). Results of selective coronary angiography were taken as gold standard for comparison. Results: VEs of 568 (568/756, 75%) coronary arteries were successfully reconstructed and 76 (76/88, 86%) coronary stenoses were detected by VE. All coronary stents (by PTCA, n=24), stent grafts (by CABG, n=4) and coronary artery fistulas (n=8) were detected by VE. Conclusion: MSCT virtual endoscopy, as a non-invasive, convenient and economical method, can accurately detect coronary stenoses and may be used for screening patients with known or suspected coronary artery diseases.