电子束CT血管造影对冠心病的诊断与术后随访价值

Evaluation of electron beam tomographic angiography in diagnosis and postoperative follow-up of 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心病的诊断和支架置入术、搭桥术后的无创性随访价值。方法 :经电子束 CT(EBT)检查的患者 14 3例 ,其中可疑冠心病 78例 ,支架置入术后复查者 52例 ,冠状动脉搭桥术后复查者 13例。 95例有冠状动脉造影 (CAG)结果证实。结果 :EBT可评价的冠状动脉中 ,以左主干和前降支的诊断敏感度、特异度最高 ,尤其是近段 ,其次为右冠 ,对回旋支的诊断敏感度和特异度则较低 ;52例支架置入术后患者共放置支架 153枚 ,EBT准确定位 150枚 ,对支架内开通诊断的符合率为 73 .9% ;13例冠状动脉搭桥术后复查的患者 ,共搭建冠状动脉桥血管 54支 ,EBT对桥血管开通与否的诊断符合率为 85.2 %。结论 :EBT对冠心病冠状动脉有意义狭窄的诊断具有较高的准确度 ,对支架术后 ,尤其是搭桥术后的复查也有较大的应用潜力 ,可部分替代有创的

AIM: To evaluate the noninvasive diagnostic a nd follow-up values of electron beam tomographic angiography (EBA) and its three-dimens i onal reconstruction techniques in coronary artery disease. METHODS: 143 patients,78 patients with suspici ous coronary artery disease, 52 patients with stents and 13 patients with coro n ary arterial bypass graft, underwent electron beam tomography(EBT). And 95 of them also underwent conventional corona ry artery angiography (CAG). RESULTS: Left main coronary artery an d left anterior descending coronary artery showed the highest diagnostic se nsitivity and sp ecificity of all the evaluated coronary arteries and the right coronary a rter y followed. The diagnostic sensitivity and specificity of the left circumfle x coronary art ery were low and not reliable. 150 stents of the total of 153 stents in 52 patient s with stents implanting were correctly localized by EBT and the diagnostic coincident rate was 73.9%. The diagnostic coincident rate of EBT in 54 coronary arterial bypass grafts of 13 patients was 85 2%. CONCLUSION: EBT is a predominant non-invasive examination techni que with h igh pre-operative screening values in coronary artery disease and good clinica l application potentials in postoperative follow-up of stents and especially cor onary arterial bypass grafts. EBT can partly substitute for invasive CAG.