64层螺旋CT冠状动脉造影扫描技术临床应用效果评价及影响图像质量的因素分析

Clinical application of 64-slice spiral CT coronary angiography and the impact factors of image quality

目的评价64层螺旋CT冠状动脉造影(MSCTA)成像技术的临床应用效果并分析影响血管图像质量的因素。方法选择100例(其中13例冠状动脉支架植入术后复查,3例冠状动脉搭桥术后复查)进行64层螺旋CT冠状动脉造影检查,并分析影响图像质量的因素。结果 100例被检者中35例CT未见异常,65例见冠状动脉各段各分支血管有不同程度的钙化斑块和狭窄(其中10例因心率>80次/min,或因吸气,屏气不好,致使部分三维冠状动脉血管图像显示欠佳,出现阶梯样伪影;11例可疑为心肌桥;3例冠状动脉搭桥术后复查,见搭桥血管形成;13例冠状动脉支架植入术后复查,见支架管腔通畅,无明显再狭窄现象)。结论 64层螺旋CT冠状动脉造影对冠状动脉成像质量好,诊断准确率高,可做为冠状动脉疾病的筛选手段及冠状动脉术后复查首选方法,图像质量受心率、呼吸和对比剂等多方面因素的影响。

Objective To investigate clinical applications of the imaging technology of 64-slice spiral CT coronary angiography （MSCTA） and the impact factors of image quality. Methods Evaluation of clinical application was performed and the factors affecting image quality were analyed in one hundred patients underwent 64-slice spiral CT coronary angiography, including thirteen patients received coronary artery stent implantation review, three patients received coronary artery by pass grafting review. Results Thirty-five patients showed normal image, sixty-five pa- tients with coronary artery showed different levels of calcified p]aque and stenosis, including ten patients with heart rate greater than 80 beats/rain or respiratory control bad showed poor image quality and ladder-like artifacts appear- anee, eleven patients were suspected as the myooardial bridge, and three patients after coronary artery bypass grafts showed good bridge, thirteen patients after coronary stent implantation showed stem lumen pateney, no significant ste- nosis phenomenon. Conclusion 64-slice CT coronary angiography with high image quality can be used as screening tools for coronary artery disease and the preferred review method of postoperative coronary artery. Image quality was affected by heart rate, respiratory control and contrast application and so on.