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目的探讨多层螺旋CT冠脉造影(multislicespiralCTcoronaryangiography,MSCTCA)的成像技术及其临床应用价值。方法对79例对象行MSCTCA检查,利用多种重建方法进行重建,分析影响冠脉成像质量的重要因素,MSCT对冠脉的显示能力,冠脉斑块性质及钙化程度,评价管腔狭窄及其程度,并对桥血管和支架的显示及通畅性进行评价。结果左冠脉主干及前降支重建的最佳时相为75%R-R时相,左回旋支及右冠脉为62.5%R-R时相。以75%的相位窗重建得到容积再现的图像为最佳。MSCTCA对冠脉1~3级分支、甚至部分4级分支显示清晰,对冠脉斑块显示良好,对冠脉狭窄显示较佳,对搭桥血管及内支架显示良好。结论16层MSCTCA可作为冠心病的筛选手段及在血运重建术后复查中有很高的临床应用价值。
Objective To investigate the imaging technique and its clinical value of multi-slice spiral CT coronary angiography (MSCTCA). Methods Totally 79 subjects were examined by MSCTCA and reconstructed by a variety of reconstruction methods. The important factors influencing the quality of coronary angiography were analyzed. The display of coronary arteries by coronary angiography, the nature of coronary plaque and the degree of calcification were evaluated by MSCT. Extent, and evaluation of the display and patency of the bridge vessels and stents. Results The optimal time of reconstruction of the left main coronary artery and the anterior descending artery was 75% R-R phase, and the left circumflex artery and the right coronary artery were 62.5% R-R phase. It is best to reconstruct the volume reproduced image with a 75% phase window. MSCTCA on the branches of the coronary artery 1 to 3, and even part of the 4 branches showed a clear, good for coronary plaque, coronary stenosis showed better on the bypass vessel and stent showed good. Conclusion 16-layer MSCTCA can be used as a screening method for coronary heart disease and has great clinical value in post-revascularization review.