论文部分内容阅读
目的对比多层螺旋CT(MSCT)和电子束CT(EBCT)冠状动脉成像的优劣势。方法23例可疑冠心病患者或查体者分别经EBCT和MSCT血管造影检查。由2名有经验的心血管专业放射诊断医师分别阅读两组资料片,将冠状动脉各支共分成4支9个节段,逐一对照两种检查方法所显示的各支冠状动脉主干的可视长度、可评价长度,各节段血管成像质量等级比率,不同三维重建方法及其对斑块的显示优势,并进行统计学分析。结果①MSCT和EBCT所显示的冠状动脉各主干血管的可视长度没有统计学差异,但对前降支和回旋支的可诊断长度显示有统计学差异(P<0.05,P<0.01)。②MSCT的A级节段比和B级节段比均高于EBCT,总的可诊断节段比明显高于EBCT(P<0.01);而C级节段比则明显低于EBCT(P<0.01)。MSCT的C级节段主要集中在运动伪影明显的右冠中段,EBCT的C级节段则主要集中在前降支和回旋支远段。③MSCT可显示EBCT无法显示的血管上、下壁的非钙化性斑块和EBCT易遗漏的管壁一侧的轻度增厚改变。④在各种三维重建方法中,除了轴位MIP血管显示两种检查方法没有明显差别,其他三维重建方法的成像清晰度MSCT均优于EBCT。结论MSCT对冠状动脉前降支和回旋支的成像及非钙化性斑块的显示优于EBCT,但右冠成像因中段频繁的运动伪影而明显劣于EBCT。EBCT和MSCT,尤其是MSCT,是极有临床应用价值和发展潜力的无创性冠状动脉成像技术,虽然不能完全替代冠状动脉造影,但可作为冠心病的常规筛选检查方法,减少有创检查。
Objective To compare the advantages and disadvantages of multislice spiral computed tomography (MSCT) and electron beam computed tomography (EBCT) coronary angiography. Methods 23 cases of suspected coronary heart disease or physical examination by EBCT and MSCT angiography. Two experienced cardiovascular professional diagnostic radiographers read two sets of data sheets respectively, which divided the branches of coronary arteries into 4 segments and 9 segments. The visualization of the trunk of each coronary artery showed by the two inspection methods one by one Length, evaluable length, quality grade ratio of each segment angiography, different 3D reconstruction methods and their display advantages for plaque, and make statistical analysis. Results ① There was no significant difference in the visual length of coronary vessels between MSCT and EBCT. However, the diagnostic length of the anterior descending branch and the circumflex artery showed a significant difference (P <0.05, P <0.01). ② The ratio of MSCT A-segment to B-segment was higher than that of EBCT, and the total diagnosable segment was significantly higher than that of EBCT (P <0.01); while the C-segment ratio was significantly lower than that of EBCT (P <0.01) ). The C-segment of MSCT mainly focused on the middle right segment of the right coronary artery with significant motion artifacts. The C-segment of EBCT mainly focused on the anterior descending branch and the circumflex artery distal segment. ③ MSCT can show the EBCT can not be displayed on the vascular wall, the non-calcified plaque and EBCT easy to miss a slight wall thickening changes. (4) In all three-dimensional reconstruction methods, except the axial MIP vessels showed no significant difference between the two methods, MSCT of other three-dimensional reconstruction methods were superior to EBCT. Conclusion MSCT is superior to EBCT in the imaging of the anterior descending coronary artery and the circumflex artery and the non-calcified plaque. However, right coronary artery imaging is obviously inferior to EBCT due to the frequent motion artifact in the middle segment. EBCT and MSCT, especially MSCT, are noninvasive techniques of coronary artery imaging with great clinical value and potential for development. Although they can not completely replace coronary angiography, they can be used as a routine screening test for coronary heart disease and reduce the invasive examination.