双源CT在冠状动脉旁路移植术后随访中的应用

Preliminary Application of Dual-Source Computed Tomography Coronary Angiography in Follow-up of Coronary Artery Bypass Grafts

目的 探讨双源CT在冠状动脉搭桥术后的临床应用及其价值.方法 对2009年1月～2010年8月期间27例冠状动脉搭桥术（CABG）后患者的CTA影像资料进行分析,对桥血冠状动脉管狭窄进行诊断.其中有10例患者同期行选择性冠状动脉造影术.结果 所有患者顺利完成冠状动脉图像采集,所有桥血管均显影,并且都可进行评价,其中共15条桥血管出现狭窄.和CAG结果相比,双源CT对狭窄判断的敏感性100%、特异性91.3%、准确率93.1%,出现狭窄的血管与血管类型有关,2年内通畅率动脉桥高于静脉桥.结论 双源CT可以准确评价冠状动脉桥血管通畅情况,是术后评价冠状动脉桥血管病变的首选检查方法.

Objective To explore the clinical application value of dual-source computed tomography （I）SCT） in follow-up for patients underwent Coronary Artery Bypass Grafting（CABG）. Methods Reconstructing the CTA image data of 27 patients after CABG and evaluating the obtained images. Selective coronary angiography were performed in ten patients whose stenosis evaluated by DSCT. Results All coronary artery bypass grafts of patients were clearly displayed by DSCT. Fifteen coronary artery bypass grafts had stenosis including twelve branches of great saphe- nous veins,two branch of left internal mammary artery and one branch of radial artery. Ten of the patients performed se- lective coronary angiography. Comparing with CAG,the sensitivity,specificity and accuracy of the DSCT were 100% ,91. 3% and 93.1% respectively. There was correlation between the occluded grafts and grafts source. The patency rate of the SVG was better than the artery. There was no correlation between the occluded grafts and time after the operation. Conclusion The DSCT is an accurate and reliable method for evaluation of bypass graft patency or stenosis. It may be the first choice of evaluation for bypass grafts.