64排螺旋CT评价冠状动脉旁路移植术后桥血管的效果

Effect of 64-multislice spiral CT evaluating coronary vascular bridge in patients after coronary artery bypass grafting

目的:探讨64排螺旋CT在冠状动脉桥血管的临床应用价值。方法:对42例冠状动脉旁路术后病人,共145条桥血管(其中内乳动脉46条,大隐静脉桥99条),进行64排螺旋CT造影(CTA)。CT扫描时病人的平均心室率为(60±5)次/min。42例中20例桥血管血管吻合口冠状动脉狭窄(≥50%)或闭塞的病人及7例吻合口远端狭窄或闭塞的病人同时进行了冠状动脉造影(CAG)。结果:42例病人CTA均可评价,显示桥血管通畅125条,闭塞20条(其中内乳动脉5条,静脉桥15条)。CTA诊断冠状动脉桥血管狭窄(≥50%)或闭塞的准确性达100%。结论:CTA可以准确评价冠状动脉桥血管以及吻合口再狭窄的程度,桥血管近端吻合口的位置,可提示冠状动脉桥血管术后CAG的径路,是评价冠状动脉桥血管病变,创伤性小的首选方法。

Objective： To investigate the value of 64--multislice spiral evaluating coronary vascular bridge in patients after coronary artery bypass grafting （CABG）. Methods： The 42 patients after CABG, a total of 145 bridges blood vessels （including internal mammary artery 46, saphenous vein bridge 99）, were evaluated by 64-- multislice CT angiography （CTA）. Twenty patients with bridge vascular anastomotic stoma stenosis （≥50%） or occlusion and seven patients with distal anastomotic stenosis or occlusion were also performed coronary angiography （CAG）. Results： The CTA of 42 patients was all distinctly evaluated, it show 125 bridge blood vessels were easy and smooth ; and 20 bridge blood vessels were occlusion （including five in mammary artery, 15 in vein bridge） ; were all coincidence with CAG （accuracy was 100%）. Conclusion： CTA could accurately evaluate coronary vascular and anastomotic stenosis and show visual bridge vessel proximal anastomotic place to guide CAG approach after coronary artery bypass grafting.