16 层螺旋CT 冠状动脉成像初步探讨

16 层螺旋CT 冠状动脉成像初步探讨
朱海峰 范家栋 郑卓肇 何汇忱 舒邦明
【摘要】 目的 探讨心率与多层螺旋CT( MSCT) 冠状动脉( 简称冠脉) 成像运动伪影的关系, 及
MSCT 冠脉成像的临床应用价值。方法 对200 例临床拟诊冠心病的患者行MSCT 冠脉成像检查, 分
析扫描时心率与冠脉运动伪影的关系; 其中37 例同时行常规冠脉造影( 简称冠造) 检查, 对比分析
2 种检查结果。结果 扫描时心率≤ 55 次/min、56 ～60 次/min、61 ～65 次/min、66 ～70 次/min
和> 70 次/min组有运动伪影的冠脉节段分别占冠脉总数的0. 1% ( 1 /759) 、1. 1% ( 7 /649) 、2. 5%
( 10 /407) 、42. 6% ( 103 /242) 和75. 5% ( 108 /143) ; 以常规冠造作为金标准, MSCT 诊断狭窄≥50% 的
敏感度、特异度、阳性预测值、阴性预测值分别为79. 2% 、96. 0% 、83. 8% 、94. 6% 。扫描时心率与冠脉
运动伪影的数量显著相关( r = 0. 655, P = 0. 000) 。结论 MSCT 能较准确诊断冠脉50% 以上的狭窄,
是无创性诊断冠脉狭窄的重要工具。
【关键词】 冠状动脉疾病; 体层摄影术, X 线计算机; 心血管造影术
Initial experiences about 16-detector row CT corona ry a ngiogra phy ZHU Hai-feng* , FAN J ia-dong,
ZHENG Zhuo-zhao, HE Hui-chen, SHU Bang-ming. * Department of Radiology, CAAC General Hospital,
Beijing 100025, China
【Abstra ct 】 Object ive To investigate the influence of a patient′s heart rate on the presence of
motion artifacts and on accuracy of stenosis detection on contrast-enhanced MSCT. Methods Two hundred
patients with suspected coronary artery disease underwent the contrast-enhance MSCT, the main factors
influencing imaging quality were analyzed. Thirty-seven patients underwent conventional selective coronary
angiography in the same time. The results obtained from MSCT were compared. Results In the 5 groups
( heart rate≤55 bpm, 56—60 bpm, 61—65 bpm, 66—70 bpm, > 70 bpm during scan) , the proportion of
segments that could not be assessed because of motion artifact were 0. 1% ( 1 / 759) , 1. 1% ( 7 / 649) , 2. 5%
( 10 /407 ) , 42. 6% ( 103 /242 ) , and 75. 5% ( 108 /143 ) , respectively. With conventional selective
coronary angiography as the golden standard, the sensitivity, specificity, positive and negative prediction
values to detect ≥ 50% stenotic lesions in the assessable segments were 79. 2% , 96. 0% , 83. 8% , and
94. 6% , respectively. There was a significant correlation between the number of segments per patient not
assessable because of motion artifact and heart rate during the scan ( r = 0. 655, P = 0. 000 ) . Conclusion
MSCT is capable of achieving high accuracy for detection of coronary artery stenosis, and is a reliable
technique to diagnose coronary artery disease.
【Key wor ds】 Coronary disease; Tomography, X-ray computed; Angiocardiography

16 层螺旋CT 冠状动脉成像初步探讨--心血管.rar