多层螺旋CT在冠状动脉搭桥术后的临床应用

Clinical application of coronary artery bypass grafts with multi-slice spiral CT

目的评价多层螺旋CT(MSCT)在冠状动脉搭桥术后的应用价值。方法对40例冠状动脉搭桥术后患者,共有搭桥血管93条(乳内动脉30条,大隐静脉63条)。对40例患者分别行螺旋CT增强扫描和选择性冠状动脉造影(SCA)检查。所有MSCT检查采用回顾性心电门控技术、分段数据采集方式和选择75%的时间相位窗,对扫描数据进行后处理,由两位富有经验的医师评估并与SCA结果对照。结果所有近端桥血管及71.4%的远端搭桥血管通过MSCTA可显示,12条桥血管闭塞,66条通畅,13条有不同程度狭窄,1条远端桥血管狭窄并得到SCA证实,有4条假阳性,1条假阴性导致敏感性为94.5%,特异性为95.7%,阳性预测值80.4%,阴性预测值96.3%。结论多层螺旋CT可作为一种可靠的检查手段用于冠状动脉搭桥术后的评估。

Objective To assess the application of multi-slice spiral computed tomography （MSCT） in coronary artery bypass grafts. Methods A total of 40 patients with 93 coronary artery bypass grafts （internal mammary artery, 30; great saphenons vein, 63） underwent MSCTA and selective coronary arteriography （SCA）. All CT examination were performed with retrospective ECG-gating, segment method with 75% R-R interval, deal with all datums, and CT findings were compared with SCA by two experienced doctors. Results All bypass grafts and 71.4% of the distal bypass anastomoses could be visualized by MSCTA; 12 bypass grafts occlusions, 66 unobstructed, 13 stenosis, and 1 distal bypass significant stenosis confirmed by SCA. Four false positive and one false negative findings resulted in sensitivity of 94.5 %, specificity of 95.7 %, positive predictive value of 80.4 %, and negative predictive value of 96.3 %. Conclusion Multi-slice spiral CT could be used as a reliable way to assess coronary artery bypass grafts.