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目的评价MSCT冠脉造影技术对判断冠状动脉病变的价值。方法对临床疑冠心病40例和2例联合瓣膜病变以及2例冠脉搭桥术后复查患者行冠状动脉MSCT检查,行增强扫描并进行3D图像后处理,包括曲面重组(CPR)及仿真内镜(VE)、最大密度投影(MIP)等方法,观察其对冠状动脉病变的显示。结果对于血管直径≥2mm无伪影能清晰显示,满足管腔评价情况502支血管进行分析。不能满足管腔评价的血管支数为30支。心率<60次/min的管腔评价情况明显好于心率>60次/min。冠状动脉斑块情况:共57支血管发现钙化斑块。6支血管出现纤维斑块。4支血管发现软斑块。狭窄情况分析,63支钙化和纤维斑块中,轻度狭窄14支,中度狭窄20支,重度狭窄1支。4支软斑块均为重度狭窄。2例冠状动脉搭桥术后复查桥血管通畅。发现一例右侧冠状动脉发自左侧冠状动脉窦的变异。结论MSCT曲面重建结合其他方法,对诊断冠状动脉病变有重要的价值。
Objective To evaluate the value of MSCT coronary angiography in the diagnosis of coronary artery disease. Methods 40 patients with suspected coronary heart disease and 2 patients with valvular disease and 2 patients underwent coronary artery bypass graft surgery after coronary artery MSCT examination, line enhanced scanning and 3D image processing, including surface reconstruction (CPR) and simulated endoscopy (VE), maximum density projection (MIP) and other methods to observe the display of coronary lesions. The results for the vascular diameter ≥ 2mm no artifacts can be clearly displayed to meet the lumen evaluation 502 blood vessels were analyzed. Can not meet the lumen evaluation of the blood vessel count of 30. The lumen evaluation with heart rate <60 beats / min was significantly better than the heart rate> 60 beats / min. Coronary plaque conditions: a total of 57 vessels found calcified plaque. 6 blood vessels appear fibrous plaque. 4 vessels found soft plaque. Stenosis analysis, 63 calcifications and fibrous plaques, mild stenosis 14, moderate stenosis 20, severe stenosis 1. Four soft plaques were severe stenosis. 2 cases of coronary artery bypass graft bridge review patency. An example of a variant of the right coronary artery originating from the left coronary sinus was found. Conclusion MSCT surface reconstruction combined with other methods, the diagnosis of coronary artery disease has important value.