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目的:探讨64层探测器CT冠状动脉造影的临床应用价值。方法:对116例临床拟诊冠心病者行64层CTCA检查,采用多种重建方法对原始数据进行重建,观察64层CT对冠状动脉的显示能力、起源、冠脉内斑块性质及管腔狭窄程度,分析影响冠状动脉图像质量的因素,并对桥血管和支架通畅性进行观察。结果:左冠状动脉主干及前降支重建的最佳时相为75%R-R时相,左回旋支及右冠状动脉为65%R-R时相。以75%的相位窗重建得到容积再现的图像为最佳。64层CTCA对冠状动脉1～3级分支和部分4级分支显示清晰,对变异血管及心肌显示较佳;对冠状动脉内斑块、冠脉狭窄显示较佳;对桥血管及支架通畅和有无再狭窄显示良好。结论:64层探测器CTCA可作为冠心病、壁冠状动脉、血管变异及心肌病变的筛选手段及对冠状动脉血运重建术后复查有很高的临床应用价值。
Objective: To explore the clinical value of 64-detector CT coronary angiography. Methods: One hundred and sixty-six patients with clinically suspected coronary heart disease underwent 64-slice CTCA. Reconstructions of the original data were performed using various reconstructive methods. The 64-slice CT was used to evaluate coronary artery function, origin, intracranial plaque characteristics, Stenosis, analysis of the factors that affect the quality of coronary arteries, and to observe the 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% of the R-R phase, and 65% of the R-R phase of the left circumflex artery and the right coronary artery. It is best to reconstruct the volume reproduced image with a 75% phase window. 64-slice CTCA showed a clear degree of grade 1 ~ 3 branches and some grade 4 branches in coronary arteries, and showed better results in variant blood vessels and myocardium; better display of intracoronary plaque and coronary stenosis; patency of bridge vessels and stents No restenosis showed good. Conclusion: The 64-detector CTCA can be used as a screening tool for coronary heart disease, wall coronary artery, vascular variation and myocardial lesions and has a high clinical value for post-operative coronary revascularization.