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目的探讨64层螺旋CT冠状动脉成像评价冠状动脉支架通畅性的临床应用价值。方法对29例冠状动脉支架植入术后患者的59枚支架行64层螺旋CT回顾性心电门控增强扫描,扫描与支架植入术的平均间隔是(28.4±21.2)个月。采用5分制计分法评价支架的轴位多平面重建(MPR)图像及通过支架内腔中心的曲面重建(CPR)图像质量,同时测量支架内管腔直径。计算支架内管腔直径与支架近端的管腔直径比值以评价支架内腔可见度。其中5位患者有常规冠状动脉造影对照,共9个支架的通畅性得到评价。结果图像平均质量达到优良水平[(1.94±0.84)分]。图像质量与心率、呼吸运动及支架位置有关。所有59枚支架内腔均为可见,平均支架内腔可见直径比率为(76.1±11.1)%。有常规冠状动脉造影对照的9个支架均诊断为通畅,与常规冠状动脉造影结果吻合。结论64层螺旋CT冠状动脉成像可有效评价冠状动脉支架的通畅性。
Objective To evaluate the clinical value of 64-slice spiral CT coronary angiography in assessing coronary artery stent patency. Methods Totally 59 cases of 29 patients with coronary artery stenting underwent retrospective electrocardiographic gated enhancement scan with 64-slice spiral CT. The average interval between scan and stent implantation was (28.4 ± 21.2) months. Axial multiplanar reconstruction (MPR) images of scaffolds and surface reconstruction (CPR) images through the center of the scaffold were evaluated using a 5-point scoring system to measure the lumen diameter of the scaffolds. The ratio of lumen diameter in the stent to lumen diameter in the proximal end of the stent was calculated to assess stent lumen visibility. Five of the patients had conventional coronary angiography controls, and the patency of nine stents was evaluated. Results The average quality of the images reached an excellent level [(1.94 ± 0.84) points]. Image quality and heart rate, respiratory motion and stent position. All 59 stent lumens were visible, with an average stent diameter of 76.1 ± 11.1%. All 9 stents with conventional coronary angiography were diagnosed as patency, consistent with conventional coronary angiography. Conclusion 64-slice spiral CT coronary angiography can effectively evaluate the coronary artery stent patency.