e-Speed电子束CT血管造影对冠状动脉疾病诊断的临床应用

Clinical application of e-Speed electron beam computed tomography angiography in coronary artery disease

目的总结e-Speed电子束CT(electron beam computed tomography,EBCT)冠状动脉造影检查结果,探讨EBCT血管造影的图像质量及其对冠状动脉疾病的诊断价值。方法2005年4月～2006年7月疑诊冠状动脉疾病或健康查体来我院行e-Speed电子束CT冠状动脉检查病例356例,所有受检者均行EBCT冠状动脉平扫,319例行EBCT冠状动脉造影检查。结果以容积再现(VR)和曲面重建(CPR)图像为评价主要依据,参考其他图像后处理结果,将EBCT冠状动脉造影图像质量分为6个等级。优良(6～4分)图像为270例,占84.6%,3分图像37例,占11.6%,2分以下图像12例,占3.8%,2分以下图像不能进行诊断。能进行诊断的307例中,冠状动脉未见异常者211例(68.7%),冠状动脉狭窄者95例(30.9%),冠状动脉先天性异常1例。结论EBCT血管造影可清晰显示冠状动脉主干及主要分支,判断冠状动脉有无狭窄及其程度,在冠状动脉疾病诊断和介入治疗筛选方面可部分取代传统的导管法造影检查。

Objective To summarize the examination results of e-Speed electron beam computed tomography （EBCT） in coronary artery disease （CAD） and its diagnostic value. Methods Three hundred and fifty-six cases of suspected CAD or health screening were examined with e-Speed EBCT form April 2005 to July 2006. All cases were examined by plain scan and 319 cases were further examined by EBCT angiography （EBCTA）. Results According to the evaluation of volume rendering （VR） and curved planar reconstruction （CPR）, the image quality of EBCTA was classified as six grades. Good and excellent images （score 4-6） were encountered in 270 cases, images of score 3 in 37 cases and images of score 2 in 12 cases. Of 307 cases with images scored 3 and above, 211 cases had normal coronary EBCTA, 95 cases had stenotic coronary artery and the remain one had congenital abnormality of coronary artery. Conclusion EBCTA could display clearly the main coronary artery and its major branches, determine if the stenosis existed and judge its severity. EBCTA could partially replace conventional cathetering coronary artery angiography in the diagnosis of CAD and the case selection for percutaneous transluminal coronary angioplasty.