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目的评价16层螺旋CT对冠状动脉桥血管的显示能力。方法回顾性分析17例冠状动脉搭桥术(CABG)后患者的CT和选择性桥血管造影的资料,男15例,女2例,年龄51～78岁,平均(67±7)岁,术后6～85个月,平均(32±19)个月。共40支桥血管,原位乳内动脉13支,游离桡动脉11支,游离大隐静脉16支。由两位有丰富心血管影像诊断学经验的医生采用双盲法阅片,并取得一致结果。评价指标包括CT成像中桥血管的可评价性、有无闭塞或狭窄(管径缩小50%～99%)。结果所有40支桥血管均可评价,CT准确诊断5支桥血管闭塞和1支狭窄外,各有1例假阳性,其诊断桥血管闭塞与狭窄的敏感性、特异性达100%和97%,准确率分别为97.5%和97.1%。发生闭塞的血管与桥血管的类型和分布无关。结论16层螺旋CT是一种值得信赖的无创性随访研究桥血管通畅性的影像学方法。
Objective To evaluate the ability of 16-slice spiral CT to display the coronary artery vessels. Methods A retrospective analysis of 17 patients with coronary artery bypass graft (CABG) after CT and selective angiography data, 15 males and 2 females, aged 51 to 78 years, mean (67 ± 7) years of age, postoperative 6 to 85 months, with an average of (32 ± 19) months. A total of 40 bridge vessels, 13 in situ mammary artery, 11 free radial artery, 16 free saphenous vein. Two doctors who had extensive experience in cardiovascular imaging diagnostics used double-blind readings and achieved consistent results. Evaluation criteria include assessability of the bridge vessels in CT imaging, occlusion or stenosis (diameter reduction 50% to 99%). Results All 40 vessels were evaluable. CT was diagnosed correctly in 5 vessels and 1 vessel. One case was false positive. The sensitivity and specificity of diagnosing vessel occlusion and stenosis were 100% and 97% respectively. The accuracy rates were 97.5% and 97.1% respectively. The occluded vessels are not related to the type and distribution of the bridging vessels. Conclusion 16-slice spiral CT is a reliable and noninvasive follow-up imaging study of the patency of the bridge.