冠状动脉钙化多层螺旋CT检查及与冠状动脉造影的对比研究

Relation of coronary calcium detected by multislice CT and coronary angiography

目的 研究多层螺旋CT所见冠状动脉钙化与冠状动脉狭窄之间关系 ,并与冠状动脉造影进行对比。方法 2 3例临床怀疑或确诊冠心病患者 (男 17例 ,女 6例 ,年龄 3 1～ 74岁 )均行MSCT检查及冠状动脉造影。MSCT扫描采用心电门控触发成像 ,单次扫描时间为 0 .3 2s ,层厚为 2mm× 4mm。将MSCT所见钙化与常规冠状动脉造影对比。结果 5 8支发现钙化的血管中 ,78%有冠状动脉狭窄 ( >5 0 % ) ,47支造影证实冠状动脉狭窄 ( >5 0 % )的血管中 ,96%发现冠状动脉钙化。青年组与老年组相比 ,冠状动脉钙化预测冠心病的敏感性较低而特异性较高。结论 多层螺旋CT检出冠状动脉钙化简便易行 ,可广泛用于临床预测及早期诊断冠心病。

Objective To investigate the relationship between coronary calcification and significant coronary stenosis. Methods Twenty three patients including 17 men and 6 women were studied with age ranging from 31-74 years (mean 59.3 years). All patients had both multislice CT (MSCT) examination and coronary angiography within one month. Single slice mode with ECG gating were used in MSCT scan with single scan time of 0.32 s and thickness of 2 mm×4 mm. Selected coronary angiography was performed by the Judkins' technique. Results Among 58 vessels in which coronary calcifications were identified, 78% had significant coronary stenosis (>50% stenosis), and 96% of 47 vessels with significant coronary stenosis had calcification demonstrated by MSCT. In the younger age group the sensitivity of calcification for evaluating stenosis of coronary artery was lower and the specificity was generally higher than those in the elderly group. Conclusion MSCT is a promising procedure for detecting coronary arterial disease, with high sensitivity, specificity, and convenience, and be widely applicable for screening a large population.