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目的:探讨16层CT对冠状动脉粥样硬化病变的显示情况及临床价值。方法:39例患者进行16层CT冠状动脉造影检查(疑似冠心病者31例,PTCA术后8例)及选择性冠状动脉造影。分析16层CT对冠状动脉各节段的显示情况。以管腔直径减小>50%为标准,判定冠状动脉狭窄。分析16层CT诊断冠状动脉狭窄的敏感性、特异性及符合率,及对病变性质的显示情况。结果:16层CT对冠状动脉的总体显示率为94.8%(333蛐351)。评价冠状动脉病变的总体敏感性为82.2%,特异性为94.7%,符合率为86.0%。16层CT显示钙化及非钙化斑块混合存在致血管狭窄21处,高估3处;中间密度斑块致狭窄8处,高估3处;软斑块3处,无显著狭窄。16层CT能清晰显示支架位置、形态及远端血流,1例再狭窄,1例闭塞,余通畅,其结果与选择性冠状动脉造影一致。另外,16层CT显示冠状动脉起源变异2例,前降支冠状动脉瘤1例,室壁瘤1例,房间隔缺损1例。结论:16层CT冠状动脉成像是一种颇具潜力的无创性检查方法,能够较为准确、全面的评价冠状动脉病变。
Objective: To investigate the manifestation and clinical value of 16-slice CT in the diagnosis of coronary atherosclerosis. Methods: Thirty-nine patients underwent 16-slice CT coronary angiography (31 suspected coronary artery disease, 8 post PTCA) and selective coronary angiography. Analysis of 16-slice CT coronary artery segments showed. To reduce the lumen diameter> 50% as the standard, determine coronary artery stenosis. To analyze the sensitivity, specificity and coincidence rate of 16-slice CT in the diagnosis of coronary artery stenosis and to reveal the nature of the lesion. Results: The 16-slice CT showed an overall rate of coronary arteries of 94.8% (333 蛐 351). The overall sensitivity of coronary artery disease was 82.2%, the specificity was 94.7% and the coincidence rate was 86.0%. The 16-slice CT showed that there were 21 vascular stenosis caused by the presence of calcified and non-calcified plaque, which was overestimated at 3 sites. The middle density plaque was stenotic at 8 sites and overestimated at 3 sites. Soft plaque at 3 sites showed no significant stenosis. 16-slice CT can clearly show the position, shape and distal blood flow of the stent. One case of restenosis, one case of occlusion and the rest of patency were consistent with selective coronary angiography. In addition, the 16-slice CT showed 2 cases of coronary artery variation, 1 case of anterior descending coronary artery aneurysm, 1 case of aneurysm and 1 case of atrial septal defect. Conclusion: 16-slice CT coronary angiography is a potential noninvasive method to evaluate coronary artery disease more accurately and comprehensively.