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目的探讨64层螺旋CT冠状动脉血管成像(MSCT)在诊断冠状动脉狭窄时影响准确性的原因。方法冠状动脉粥样硬化性心脏病患者620例,行MSCT检查,分析影响成像质量因素,包括心率、呼吸、造影剂的应用、时相的选择和容积再现(VR)、多平面重组(MPR)、最大密度投影(MIP)和曲面重组(CPR)等图像后处理技术。结果当心率≤60次/分时,MSCT图像均达到优良;心率61～70次/分,总优良率>95%;心率71～79次/分,优良率<30%。钙化越严重,冠状动脉图像质量总的优良率越低。结论心率和冠状动脉钙化程度对冠状动脉成像质量有明显影响;行MSCT检查时,尽量控制心率在70次/分以下,减少伪影产生可提高成像质量。
Objective To investigate the causes of the accuracy of 64-slice spiral CT coronary angiography (MSCT) in the diagnosis of coronary artery stenosis. Methods Sixty-two patients with coronary atherosclerotic heart disease underwent MSCT examinations to analyze the imaging quality factors including heart rate, respiration, contrast agent application, time phase selection and volume rendering (VR), multiplanar reorganization (MPR) , Maximum density projection (MIP) and surface reconstruction (CPR) and other image processing techniques. Results When the heart rate was less than or equal to 60 beats / min, MSCT images were excellent. The heart rate was 61-70 beats / min, the total excellent rate was 95%, the heart rate was 71-79 beats / min and the excellent and good rate was less than 30%. The more severe calcification, the lower the overall excellent rate of coronary artery image quality. Conclusions The heart rate and the degree of coronary artery calcification have a significant effect on the quality of coronary artery imaging. When performing MSCT examination, the heart rate should be controlled at 70 beats / min or less. Reducing artifact can improve imaging quality.