16层螺旋CT冠状动脉造影对冠状动脉的进一步评价

The Evaluation of Coronary Artery with 16 Slices coronary Angiography

目的评价16层螺旋CT冠状动脉造影在冠状动脉疾病诊断中的价值。资料与方法本组706例受检者行16层螺旋CT冠状动脉血管造影成像检查,其中537例受检者给予常规剂量β受体阻滞剂,控制心率在(65±10)次/min,后处理采用容积再现(VR)、最大密度投影(MIP)、多平面重组(MPR)、曲面重组(CPR)以及仿真内镜(VE),分别显示冠状动脉主干及其属支(左冠状动脉主干、左前降支、左回旋支以及右冠状动脉)并对其进行评价。结果706例受检者有2556支冠状动脉被评价,其敏感性、特异性、准确性、阳性预测值、阴性预测值分别为96%、88%、89%、91%、93%。检测有意义的狭窄(≥50%的狭窄)936/2556(36.62%)支,其中钙化性狭窄773/936(82.59%),非钙化性斑块狭窄163/936(17.50%),单支血管有意义的狭窄为612/936(65.38%),两支血管有意义的狭窄为237/936(25.32%),三支以上血管有意义的狭窄为113/936(12.07%)。结论如果控制好心率和改善扫描技术,16层CT冠状动脉血管造影能较为满意地显示冠状动脉主干及其属支,对冠心病的筛查、血管搭桥以及内支架置入后疗效随访均有较大的临床应用价值。

Objective To evaluate the diagnostic value of 16 detector CT coronary angiography in coronary artery diseases. Materials and Methods 16 slices CT coronary angiography was performed in 706 patients. 537 patients were given additional βblockers. Average heart rate was 65 ±10 beats/min. The postprocess reconstruction technique included Volume Rendering （VR） , Muhiplanner Reconstruction （ MPR）, Curved Planner Reconstruction （ CPR）, Maximum Intensity Projection（ MIP）, and Virtual Endoscopy （VE）. Main coronary artery and coronary artery branches （the left main coronary artery, the left anterior descending coronary artery, the left circumflex coronary artery and the right coronary artery） were evaluated respectively. Results 706 patients （2556 coronary arterial branches） were evaluated. In 2556 branches, sensitive, specificity, accuracy, positive predictive value, and negative predictive value with muhidetector CT coronary angiography were 96%, 88%, 89%, 91%, 93%, respectively. 936/2556 （36.62%） evaluated branches were significantly difference for ≥50% stenoses, including calcified stenoses 773/936（ 82.59% ） branches, noncalcified plaque stenoses 163/936 （17.50%） branches, single branches significant stenoses 612/936 （65.38%）, two branches significant stenoses 237/936 （25.32%）, more than three branches vessels significant stenoses 113/936（12.07% ）. Conlusion With improvements in technology, combined with heart rate control, 16 MDCT coronary angiography can reveal main coronal arteries and branches satisfactorily, which has high clinical value in screening coronary heart diseases and following up coronary artery graft and stent.