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目的探讨320排动态容积CT冠状动脉计算机断层摄影血管造影(computed tomography angiography,CTA)在冠状动脉支架植入术后随访中的临床应用价值。方法采用320排动态容积CT扫描,对58例冠状动脉支架植入术后患者可评估的137枚冠状动脉支架、支架近端及远端血管、非支架血管进行重建和分析,评价其通畅性。结果 CTA清晰显示了冠状动脉支架植入的位置、支架数量和管腔密度、有无支架内再狭窄、非支架血管病变以及心脏其它方面的病变。支架通畅131枚,支架内狭窄4枚,闭塞2枚,支架前后血管狭窄30支,非支架血管狭窄47支,其中钙化病变20处,非钙化病变57处。结论 320排动态容积CT扫描能够清晰显示冠状动脉支架内再狭窄情况及非支架血管病变性质,可作为PCI术后效果随访观察和了解原有冠心病进展情况的重要方法。
Objective To investigate the clinical value of 320-row dynamic volume CT coronary computed tomography angiography (CTA) in the follow-up of coronary stenting. Methods A total of 137 coronary stents, proximal and distal vessels, and non-stent grafts of 58 patients undergoing coronary stent implantation were reconstructed and analyzed with 320-row dynamic volume CT scan to evaluate the patency. Results CTA clearly demonstrated the location of coronary stent implantation, the number of stents and luminal densities, the presence or absence of in-stent restenosis, non-stenting vascular lesions, and other cardiac pathologies. There were 131 stents, 4 stenosis and 2 occlusions, 30 stenosis before and after stents, 47 non-stenosis vessels, including 20 calcified lesions and 57 noncalcified lesions. Conclusions The 320-row dynamic volume CT scan can clearly show the coronary stent restenosis and the characteristics of non-stent-based vascular lesions, and can be used as an important method for follow-up of the effect of PCI and for understanding the progress of the original coronary heart disease.