320排640层动态容积CT胸痛三联检查在急性胸痛病因鉴别诊断中的价值

Value of “Triple rule-out” of Chest Pain Using 320-Row Detector 640 Layers Dynamic Volume CT in the Acute Chest Pain Etiological Antidiastole

目的:评价320排640层动态容积CT胸痛三联检查在急性胸痛病因鉴别诊断中的价值。方法:67例急性胸痛患者行320排640层动态容积CT三联检查,同时选择性接受心电图,心脏超声,生化标志物及传统冠状动脉造影检查。结果:①67例主动脉及肺动脉CT图像全部满足评价要求。总体冠状动脉图像质量优者占84.7%,良占13.2%,差占2.1%。②CT诊断急性肺动脉栓塞8例,主动脉夹层12例,急性冠状动脉综合征(ACS)9例,冠状动脉瘘出血破入心包1例,肺感染伴胸腔积液7例,肺癌5例,心房粘液瘤2例,食道穿孔4例,未见异常20例。47例CT阳性结果中,除1例ACS假阳性外均与出院最终诊断一致;20例阴性结果中,15例与最终诊断一致。结论:320排640层动态容积CT胸痛三联检查对器质性急性胸痛病因诊断有极高准确性。

Objective：To evaluate the value of ＂triple rule-out＂of chest pain using 320-row detector 640 layers dynamic volume CT in the acute chest pain etiological antidiastole.Methods：67 cases who presented with acute chest pain were included in the study.All of the patients underwent triple examination of chest pain using 320-row detector 640 layers dynamic volume CT,all of they selected simultaneously the examination of the electrocardiogram,the heart hypersound,biochemical marker and traditional coronary arteriongraphy.Results：①The image quality of aorta and arteria pulmonalis in 67 patients was satisfied to the standard of evaluation.In images of aeteria coronaria,the excellent images were 84.7%,the acceptable images were 13.2%,the unevaluable images were 2.1%.②In 67 cases,8 cases with acute pulmonary embolism were found,12 cases with dissection of aorta were found,9 cases with acute aeteria coronaria syndrome were found,1 case with aeteria coronaria fistula to bleed in arcula cordis were found,7 cases with lung infection to accompany the hydrothorax were found,4 cases with lung cancer were found,2 cases with atrial myxoma were found,4 cases with esophagus perforation were found,20 cases were no anomaly.In the positive results of 47 cases,the results of 46 cases accorded with the final diagnosis except 1 case with the false positive result of acute aeteria coronaria syndrome.In the negative results of 20 cases,the results of 15 cases accorded with the final diagnosis.Conclusion：Triple examination of chest pain using 320-row detector 640 layers dynamic volume CT is extremely accurate for the etiological diagnoses of organic acute chest pain.