16层螺旋CT冠状动脉成像在冠心病中的应用

The clinical values of 16-slice computed tomography coronary angiography in the detection of coronary artery disease

目的探讨16层螺旋CT冠状动脉成像的图像质量和诊断冠状动脉狭窄的价值。方法对99例临床怀疑冠心病患者进行16层螺旋CT回顾性心电门控增强扫描,用容积再现(VR)、曲面重组(CPR)、多平面重建(MPR)和最大密度投影(MIP)技术重组图像,其中24例有常规X线冠状动脉造影对照。结果99例中58例(58.6%)图像质量1级,34例(34.3%)2级,7例(7.1%)3级。VR、MIP及MPR重组像显示1、2级冠状动脉达95%,3级50%左右,4级显示困难。16层螺旋CT冠状动脉成像诊断不同程度冠状动脉狭窄的敏感度为70.7%,特异度为96.4%。结论16层螺旋CT冠状动脉成像是一种无创、快速的成像方法,诊断冠状动脉狭窄有较高的敏感度和特异度,适合于冠心病患者的筛选检查。

Objective To evaluate the cy in the assessment of coronary artery image quality of coronary CT angiography （CTA） stenosis with a 16-slice CT scanner. Methods and the diagnostic accura- 99 patients with suspected coronary artery disease were detected by retrospectively ECG-gated 16-slice spiral CT coronary angiography ;twentyfour of them also underwent conventional coronary angiography. The raw data were retrospectively reconstructed under volume rendering （ VR）, muhiplannar reformation （ MPR ）, curved plannar reconstruction （CPR） and maximum intensity projection（MIP）. Results Of the ninety-nine patients,58（58.6% ）patientsimage quality were excellent, 34 （ 34. 3 % ） sufficient and 7 （ 7. 1% ） insufficient, The visibility of the first and second branches was more than 95%, the third branches was about 50%, the fourth branches had poor visibility. Compared with CCA, the sensitivity,specificity,positive and negative predictive value of 16-slice CT angiography to identify coronary stenosis were 70. 7%, 96.4%, 83.7% and 93.7% ,respectively. Conclusion 16-slice spiral CT coronary angiography has excellent sensitivity and specificity in detecting CAD,it is a noninvasive and fast coronary angiography. As a alternative method it is useful for detecting coronary artery disease.