电子束CT血管造影对冠状动脉疾病的诊断与随访

Diagnosis and Follow-up of Electron Beam CT Angiography in Coronary Artery Disease

目的 评价电子束CT血管造影 (EBA)及其三维血管成像技术对冠状动脉疾病的诊断与随访价值。资料与方法 87例经EBA检查的患者 ,其中支架置入术后随访 16例 ,搭桥术后随访 9例。除 9例搭桥患者外 ,其余 78例均有冠状动脉造影 (CAG)结果证实。结果 EBA可评价的冠状动脉中 ,对左主干和前降支的诊断敏感性、特异性最高 ,尤其是近段 ,其次为右冠 ,对回旋支的诊断敏感性和特异性则较低 ;16例支架置入术后患者共放置支架 4 7枚 ,EBA准确定位 4 5枚 (95 .7% ) ,对支架内开通诊断的符合率为 74 .5 % ;9例冠状动脉搭桥术后的患者 ,共搭建冠状动脉桥血管 2 7支 ,EBA对桥血管开通与否诊断的符合率为 81.5 %。结论 EBA对冠状动脉狭窄的诊断具有较高的术前筛选价值 ,对术后的随访也有较大的潜力 。

Objective To evaluate the diagnostic and follow up values of coronary artery disease with electron beam CT angiography (EBA) and its there dimensional reconstruction techniques. Materials and Methods 87 patients of coronary artery disease, including 16 cases with stenting and 9 with coronary arterial bypass grafts, were performed EBA. Additionally, 78 of 87 patients except 9 cases of coronary arterial bypass graft, were confirmed by conventional coronary artery angiography(CAG). Results Left main coronary artery and left anterior descending coronary artery were of highest diagnostic sensitivity and specificity in all evaluable coronary arteries and then was right coronary artery. The diagnostic sensitivity and specificity of left circumflex coronary artery were low and not reliable. EBCT accurately localized 45 of total 47 stents and the diagnostic coincident rate of stent patent was 74.5%. The diagnostic coincident rate of graft patent by EBCT was 81.5% in 27 coronary arterial bypass grafts of 9 patients. Conclusion EBCT is a predominanting non invasive screening method with high values preoperative and potential in follow up postoperative.