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1、雙源CT冠狀動(dòng)脈血管成像的臨床應(yīng)用TheClinicalApplicationofDual-sourceComputedTomographyCoronaryAngiography楊貞勇謝學(xué)斌郭漢霖YangZhen-yongXieXue-binGuoHan-li澳門鏡湖醫(yī)院影像中心DepartmentofImaging,KiangWuHospital,MacauSAR,China中圖分類號(hào):R814.42文獻(xiàn)標(biāo)識(shí)碼:A文章編號(hào):1818-0086(2010)04摘要:目的探討雙源CT(DSCT)冠狀動(dòng)脈成像的臨床應(yīng)用價(jià)值
2、。方法回顧性分析2009.6~2010.2期間139例行雙源CT(DSCT)冠狀動(dòng)脈成像檢查的病例,男75例,女64例,年齡43~76歲。圖像品質(zhì)評(píng)價(jià)分4級(jí):優(yōu)秀(4分),無偽影,完全可進(jìn)行影像學(xué)分析;良好(3分),輕微偽影,有良好的診斷品質(zhì),可進(jìn)行影像學(xué)分析;尚可(2分),中度偽影,能滿足診斷分析;差(1分),嚴(yán)重偽影,不能滿足診斷分析。狹窄程度評(píng)價(jià)方法:血管狹窄程度=(狹窄血管近心端正常血管直徑-狹窄處直徑)/狹窄近心端血管直徑×100%;冠狀動(dòng)脈狹窄分級(jí):輕度為管徑狹窄<50%,中度為≥50%且≤75%,重度≥7
3、5%,血管閉塞(100%)。結(jié)果139例冠狀動(dòng)脈成像,137例顯示良好(2分以上),符合診斷要求。CTA成像成功率98.6%,發(fā)現(xiàn)血管異常85例,其中冠狀動(dòng)脈斑塊所致狹窄70例,冠狀動(dòng)脈肌橋32例,冠狀動(dòng)脈起源異常5例(4例為右冠狀動(dòng)脈異位起源于左冠狀動(dòng)脈竇,1例為冠狀動(dòng)脈起源于冠狀動(dòng)脈竇上方),主動(dòng)脈瓣結(jié)節(jié)1例,冠狀動(dòng)脈-肺動(dòng)脈瘺1例,雙側(cè)上腔靜脈1例。同時(shí)行雙源CT冠狀動(dòng)脈成像和冠狀動(dòng)脈造影檢查(CAG)病人17例,符合率94%。結(jié)論雙源CT(DSCT)冠狀動(dòng)脈成像能提供滿意的圖像及可靠的診斷結(jié)果,以其無創(chuàng)性優(yōu)勢(shì)可
4、作為冠心病的首要篩選檢查方法之一關(guān)鍵字:冠狀動(dòng)脈;雙源CT;血管造影術(shù)Abstract:ObjectiveToevaluatetheclinicalapplicationofdual-sourcecomputedtomographycoronaryangiography(DSCTCA).MethodsBetweenJune2009andFebruary2010,dual-sourcecomputedtomographycoronaryangiography(DSCTCA)wasperformedin139cases(m
5、ale75,female64,agefrom43to76years).Imagequalitydegrees:excellent(Score4):noartifact;good(Score3):alittleartifactthatdoesnotaffectthediagnosis;satisfaction(Score2):moderateartifactthatdoesnotaffectthediagnosissignificantly;poor(Score1):seriousartifactthataffectth
6、ediagnosissignificantly.Stenosisdegrees:mildstenosis<50%,50%≥moderatestenosis≤75%,seriousstenosis≥75%,occlusion(100%).ResultsTheimagesof137of139cases(98.6%)aresatisfiedorabove.Thereare85abnormalcasesof139found.Amongthem,stenosesarefoundin70cases,myocardialbridgi
7、ngin32cases,abnormalarisingpositionin5cases(RCAoriginatesfromleftcoronarysinusin4cases,bothRCAandLCAoriginatefromthepointsabovecoronarysinusin1case),noduleataorticvalveleafletin1case,bothRCAandLCA-PAfistula1case,bothSVCin1case.94%gotthesamediagnosisin17casesthat
8、werealsoexaminedbyconventionalcoronaryangiography(CAG).ConclusionDual-sourcecomputedtomographycoronaryangiography(DSCTCA)canprovidesatisfiedimagesanddiagnosis.Itcanbe