64排螺旋CT冠状动脉血管成像在诊断冠心病中的临床应用

Clinical application of 64-slice spiral CT coronary angiography in diagnosis of coronary artery disease

目的探讨64排螺旋CT冠状动脉血管成像在显示冠状动脉狭窄中的优势及在冠心病诊断中的临床应用价值。方法选择2013年4月至2014年12月可疑冠心病患者39例,所有患者均行64排螺旋CT冠状动脉血管成像检查,回顾性心动门控,检查数据传输到Syngvia工作站,采用图像质量最佳时相进行容积再现(VR)、最大密度投影(MIP)、曲面重建(CPR)等,应用冠脉血管分析软件对冠状动脉血管进行分析评价。结果 78例中冠状动脉狭窄74例,阳性率为(94.73%),其中轻度狭窄26例、中度狭窄36例、重度狭窄12例、无狭窄4例。冠心病48例。狭窄区斑块:钙化性斑块26节段,非钙化性斑块158节段,混合性斑块170节段。冠脉开口变异4例。结论 64排螺旋CT冠状动脉血管成像在冠状动脉狭窄的诊断中具有无创、快速、安全、可靠等优点,在显示冠脉狭窄的同时无创性评价冠脉粥样硬化斑块的性质,同时可显示冠脉解剖变异,可作为冠心病的筛查、诊断及治疗前后评估的首选方法。

Objective This article was to evaluate the advantage of 64 -slice spiral CT coronary angiography （ CTCA） in showing coronary artery stenosis and its clinical value in diagnosis of coronary artery disease （ CAD） .Methods We chose 39 suspected CAD patients during April 2013 and December 2014 as study subjects.All patients were examined by using 64-slice spiral CTCA and electrocardiographic gating technique retrospectively.Acquired data was transported to work-station and analyzed by using coronary artery analyzing software.Volume rending （VR）, maximum intensity projection （MIP）, curved planar reconstruction （CPR） were performed for the analysis and assessment of coronary artery at optimal phase of image quality.Results 74 in 78 cases were found to have coronary artery stenosis, （the positive rate was 94.37%）, including 26 cases of mild stenosis, 36 cases of moderate stenosis, 12 cases of severe stenosis and 4 cases without stenosis.48 cases were diagnosed as CAD.The plaque of narrow area：calcified plaque in 26 segments, non calcified plaque in 158 segments, mixed plaque in 170 segments, crown opening variation in 4 cases.Conclusions 64 -slice spiral CTCA is a non invasive, quick, safe and reliable method in the diagnosis of coronary artery stenosis.It can display coronary artery stenosis, evaluate properties of coronary atherosclerotic plaque noninvasively and display coronary anatomic variations at the same time.64 -slice spiral CTCA can be used as preferred method for screening, diagnosis and treatment evaluation of CAD.