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1、双源CT冠状动脉血管成像的临床应用TheClinicalApplicationofDual-sourceComputedTomographyCoronaryAngiography杨贞勇谢学斌郭汉霖YangZhen-yongXieXue-binGuoHan-li澳门镜湖医院影像中心DepartmentofImaging,KiangWuHospital,MacauSAR,China中图分类号:R814.42文献标识码:A文章编号:1818-0086(2010)04摘要:目的探讨双源CT(DSCT)冠状动脉成像的临床
2、应用价值。方法回顾性分析2009.6~2010.2期间139例行双源CT(DSCT)冠状动脉成像检查的病例,男75例,女64例,年龄43~76岁。图像品质评价分4级:优秀(4分),无伪影,完全可进行影像学分析;良好(3分),轻微伪影,有良好的诊断品质,可进行影像学分析;尚可(2分),中度伪影,能满足诊断分析;差(1分),严重伪影,不能满足诊断分析。狭窄程度评价方法:血管狭窄程度=(狭窄血管近心端正常血管直径-狭窄处直径)/狭窄近心端血管直径×100%;冠状动脉狭窄分级:轻度为管径狭窄<50%,中度为≥50%且≤
3、75%,重度≥75%,血管闭塞(100%)。结果139例冠状动脉成像,137例显示良好(2分以上),符合诊断要求。CTA成像成功率98.6%,发现血管异常85例,其中冠状动脉斑块所致狭窄70例,冠状动脉肌桥32例,冠状动脉起源异常5例(4例为右冠状动脉异位起源于左冠状动脉窦,1例为冠状动脉起源于冠状动脉窦上方),主动脉瓣结节1例,冠状动脉-肺动脉瘘1例,双侧上腔静脉1例。同时行双源CT冠状动脉成像和冠状动脉造影检查(CAG)病人17例,符合率94%。结论双源CT(DSCT)冠状动脉成像能提供满意的图像及可靠的诊
4、断结果,以其无创性优势可作为冠心病的首要筛选检查方法之一关键字:冠状动脉;双源CT;血管造影术Abstract:ObjectiveToevaluatetheclinicalapplicationofdual-sourcecomputedtomographycoronaryangiography(DSCTCA).MethodsBetweenJune2009andFebruary2010,dual-sourcecomputedtomographycoronaryangiography(DSCTCA)wasperfo
5、rmedin139cases(male75,female64,agefrom43to76years).Imagequalitydegrees:excellent(Score4):noartifact;good(Score3):alittleartifactthatdoesnotaffectthediagnosis;satisfaction(Score2):moderateartifactthatdoesnotaffectthediagnosissignificantly;poor(Score1):serious
6、artifactthataffectthediagnosissignificantly.Stenosisdegrees:mildstenosis<50%,50%≥moderatestenosis≤75%,seriousstenosis≥75%,occlusion(100%).ResultsTheimagesof137of139cases(98.6%)aresatisfiedorabove.Thereare85abnormalcasesof139found.Amongthem,stenosesarefoundin
7、70cases,myocardialbridgingin32cases,abnormalarisingpositionin5cases(RCAoriginatesfromleftcoronarysinusin4cases,bothRCAandLCAoriginatefromthepointsabovecoronarysinusin1case),noduleataorticvalveleafletin1case,bothRCAandLCA-PAfistula1case,bothSVCin1case.94%gott
8、hesamediagnosisin17casesthatwerealsoexaminedbyconventionalcoronaryangiography(CAG).ConclusionDual-sourcelocatedintheTomb,DongShenJiabang,deferthenextdayfocusedontheassassination.Linping,Zhejiang