多层螺旋CT心功能检测在冠状动脉搭桥术疗效评价中的研究

The Evaluation of Multi-slice Spiral CT Cardiac Function in the Evaluation of Coronary Artery Bypass Grafting

目的:应用多层螺旋CT(MSCT)对冠心病患者冠脉搭桥术前后左心功能进行检测,并对搭桥术后桥血管内情况进行观察以评价冠脉搭桥术的疗效。方法:回顾性分析38例(桥血管86支)患者采用Ejection-Fraction软件及容积再现(VR)、多平面重组(MPR),分析冠脉搭桥手术前后左心功能的变化并观察桥血管内斑块形成及再狭窄情况。结果:多层螺旋CT显示8例患者(8.1%)桥血管内血栓形成致再狭窄,2支(2.3%)桥血管完全闭塞;术后患者左心射血分数较术前有显著改善(44.13±8.52VS39.26±7.46,P<0.05)。术后左心功能指数EF的变化率为10.79±7.81;8例患者(共9支)发生桥血管狭窄,EF变化率为为6.87±4.71。结论:多层螺旋CT可以在清晰观察桥血管的同时检测左心功能,从而对冠状动脉搭桥术的疗效进行评估,是一种可靠的检查手段。

Objective： To detect left ventricular function before and after coronary artery bypass grafting in patients with coronary artery disease with multi slice spiral CT（MSCT） and to evaluate the treatment effect after CABG. Methods： A retrospective analysis of 38 patients（86 branches of bridging vessels） was performed by Ejection-Fraction software,volume rendering（VR） and multiplanar reformation（MPR）. The changes of left ventricular function before and after coronary artery bypass graft surgery were analyzed,and the plaque formation and restenosis in the bridge were observed. Results： Multi slice spiral CT showed that 8 patients（8.1%） had restenosis caused by intravascular thrombosis,and 2（2.3%） were completely obliterate.Postoperative left ventricular ejection fraction was significantly improved compared with that before operation（44.13 ＋ 8.52 VS 39.26 ＋ 7.46,P 〈 0.05）. The change rate of left ventricular function index EF was 10.79＋ 7.81 after operation,and 8 cases（total 9） had stenosis of bridge vessel,and the rate of change of EF was6.87 ＋ 4.71. Conclusion： Multi slice spiral CT can clearly observe the bridge vessels and detect left ventricular function at the same time,so as to evaluate the curative effect of coronary artery bypass grafting. It is a reliable examination method.