16层螺旋CT在冠状动脉成像的临床应用

目的利用16层螺旋CT对临床拟诊冠心病患者行冠状动脉成像（冠脉CTA），评价其临床应用价值。方法125例受检者能屏气时间≥18S，控制心率在（65±10）次／min，行16层螺旋CT冠脉CTA检查，利用血管分析软件对图像进行后处理，主要采用容积再现（VR）、多平面重建（MPR）、曲面重建（CPR）．最大密度投影（MIP），对冠脉CTA图像质量进行评价，其中21例患者的冠脉CTA结果与冠状动脉导管造影检查（CAG）进行了对照分析。结果采用相对值或绝对值时间法重组心脏客积数据。对128例患者中512支血管进行成像质量分析：质量优．良、中和差分别为22．5％（115支），41．0％（210支），24．4％（125支）和12．1％（62支），可用于诊断评价的血管为87．9％（450支）。21例与CAG进行对照，共分析冠状动脉血管84支，CTA诊断血管狭窄程度≥50％的敏感性、特异性．阳性预测值和阴性预测值分别为91．6％、89．6％、86．8％和93．5％。结论利用16层CT行冠脉CTA，虽然时间分辨率和空间分辨率比不上更多层数的高挡CT，但充分做好病人扫描前准备和合理的扫描，重建方法，仍可迟到较高的检查成功率。

Clinical Application of Coronary Angiography with 16-slice Spiral CT

Objective To evaluate the clinical value of 16-slice spiral CT coronary angiography（MSCTCA） in diagnosis of coronary heart diseases（CHD）.Methods 125 patients, who can hold respiration more than 18 seconds and the average heart rate was 65 - 10 beats/minite, were studied by 16-slire MSCTCA. All patients were examined in ordinary scanning and coronary artery scanning with the technique of retrospective electrocardiography gating,and volume reconstructio（VR）, multiplanar reconstruction（MPR）and curved planner reconstruction（CPR）,maximum intensity projection（MIP）. 21 patients were studied by coronary angiography（CAG）,the results were compared with 16-slice MSCTCA.Results Heart volume data were recombinated by relative or absolute time method. The quality of images of 512 blood vessels of 128 patients were analyzed. 115 blood vessels（22.5%） were very good,210 blood vessels （41.0%） were good,125 blood vessels（24.4%） were general, 62 blood vessels（12.1%） were bad.450 blood vessels（87.9%） can be used for diagnosis.The images of MSCTCA of 21 patients with total 84 blood vessels were compared with CAG.The sensitiviy,specificity, positive predictive value and negative predictive value of MSCTCA for angiostegnosis more than 50% were 91.6%, 89.6%, 86.8% and 93.5%.Conclusion The time resolution and space resolution of Coronary Angiography with 16-slice Spiral CT（MSCTCA） isn＇t as good as 04-slico spiral CT. But the higher achievement ratio can he gotten with the good preparing, reasonable scanning and reconstituted method.