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目的以临床单支病变靶血管冠脉介入的角度为参照,对冠脉造影三维定量分析软件快速生成靶血管最佳投照角度进行对比研究。方法回顾性随机抽取2009-05-2009-11于我院接受冠状动脉造影并行介入治疗的患者60例,65处靶病变中血管段的影像资料,纳入62处为研究对象(有3例右冠造影因仅有单幅投照无法实现三维重建而排除)。从靶病变两个视图的投照影像中重建出三维靶血管并生成对靶血管有最少短缩或延长率的最佳投照角度。然后由两名有经验的术者以介入治疗时使用的投照角度为参照,评价三维重建生成的最佳投照角度的相对优越性,评价结果量化为从-2至2等5个评分等级。并对最佳投照角度和介入角度的短缩率及靶血管生成最佳投照度所需投照次数(等于实现三维重建的投照次数)和介入时发现较理想的投照角度的所需次数进行对比。结果成功实现62例靶血管三维重建,三维重建可实现率为100%,三维重建后自动生成的最佳投照角度评分高于实际介入使用的投照角度(最佳角度平均评分1.41±0.62,P<0.01),靶血管在最佳投照角度下的二维长度短缩率明显小于介入采用投照角度的短缩率(2.35±2.10比9.27±7.82,P<0.01),并能明显减少靶血管投照角度次数(2.08±0.27比2.50±0.65,P<0.01)。结论 Medis3D系统能准确且快速地生成用于冠状动脉介入治疗的最佳投照角度,最佳投照角度有较少的短缩率,并能减少靶血管所需的X线投照次数。
Objective To compare the coronary artery angiography coronary angiography with coronary angiography, and to make a comparative study of the best angiographic target angiography of coronary angiography. Methods A retrospective study was conducted on 60 cases of 60 patients with coronary lesions undergoing coronary angiography in our hospital from May 2009 to September 2009, including image data of 65 vascular lesion segments. Totally 62 subjects were included in the study (3 right coronary Contrast excluded because only a single projection can not be three-dimensional reconstruction excluded). Reconstruction of three-dimensional target vessels from the projection images of the target lesion and the generation of the optimal projection angle with the least amount of shortening or extension of the target vessel. Then, two experienced surgeons used the projection angle used in the intervention as a reference to evaluate the relative superiority of the optimal projection angle generated by 3D reconstruction. The evaluation results were quantified from 5 to 5 . The optimal number of shots (equal to the number of shots for three-dimensional reconstruction) needed to find the optimal projection angle during intervention and the shortening ratio of the best shot angle and interventional angle, Compare the number of times. Results The successful reconstruction of target vessel in 62 cases achieved 100% 3D reconstruction, and the optimal projection angle automatically generated after three-dimensional reconstruction was higher than the actual projection angle (the best angle average score was 1.41 ± 0.62, P <0.01). The two-dimensional shortening rate of the target vessel under the optimal irradiation angle was significantly smaller than that of the interventional irradiation angle (2.35 ± 2.10 vs. 9.27 ± 7.82, P <0.01) The number of target vessel firing angles (2.08 ± 0.27 vs 2.50 ± 0.65, P <0.01). Conclusion The Medis3D system can accurately and quickly generate the optimal projection angle for coronary intervention. The optimal projection angle has less shortening rate and can reduce the number of X-ray shots required for the target vessel.