多层螺旋CT冠状动脉血管成像技术及临床应用(1)
[摘要] 目的 分析多层螺旋CT冠状动脉血管成像技术临床应用价值，总结应用经验。方法 方便选取2015年1月—2017年2月福州总院九五医院临床部放射科医院共开展冠脉螺旋CT冠状动脉血管成像294例次。评价成像质量、冠脉血管段显示率，各类心脏并显示情况。对比CT评估高风险以及低风险对象最终手术治疗或出现心脏不良事件率。 结果成像质量满意率100.00%，冠脉血管段显示89.41%(3 943/15×294)。诊断冠心病、心肌桥、左心功能不良、先天冠脉血管发育异常等疾病，冠脉血管造影与CT诊断符合率为100.00%(24/24)。CT评估高风险患者采用手术治疗或出现心脏不良事件率高于低风险对象，差异有统计学意义(P<0.05)。CT检查期间，出现不良反应2例。 结论 多层螺旋CT冠状动脉血管成像技术可用于疾病診断、风险预测、治疗方式和选择指导、疗效评价等，但也存在不良反应，对部分冠脉段显示不清。
[关键词] 冠状动脉；血管成像；多层螺旋CT；诊断
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2017)10(b)-0185-03
[Abstract] Objective This paper tries to analyze the multi-slice spiral CT coronary angiography technique and its clinical application value and to summarize the clinical experience. Methods From January 2015 to February 2017， 294 cases of CT coronary artery angiography were carried out. The imaging quality， coronary artery segment display rate， various types of heart disease were convenient selected. The adverse events rate of heart disease diagnosed by CT of high risk subjects and low risk subjects was compared. Results The satisfaction rate of the imaging quality was 100.00%， coronary vascular segments display accounted for 89.41%(3 943/15×294). In the diagnosis of coronary heart disease， myocardial bridge， left ventricular dysfunction， congenital coronary vascular development abnormality， the coincidence rate of coronary angiography and CT diagnosis was 100.00%(24/24). CT assessment of high risk patients with surgery or adverse cardiac events was higher than that of low risk subjects， the difference was statistically significant(P<0.05). During the CT examination， 2 cases had adverse reactions. Conclusion Multi-slice spiral CT coronary angiography technology can be used in disease diagnosis， risk prediction， treatment and selection of guidance， evaluation of curative effect， but there are also some bad reactions， such as unclear display of part of coronary section.
[Key words] Coronary artery； Angiography； Multi-slice spiral CT； Diagnosis
冠脉病变是一种常见病，以血管造影成像为诊断“金标准”，但这种技术具有创伤性，患者接受率低，适应症狭窄。在我国，因高血压等疾病发生率显著上升，人口老龄化，冠脉病变开始成为常见病、多发病，如冠心病发病率已达到1%～2%[1]。以冠心病为代表的冠脉疾病，是心律失常、心力衰竭、急性冠脉综合症等重要危险因素。参照美国，可以预见冠脉病变将成为我国居民死亡的主要病因之一。多排螺旋CT冠状动脉血管成像是诊断冠脉病变的重要技术，相较于“金标准”，有创伤性小、更为安全等优势。2015年1月—2017年2月，医院共开展冠脉螺旋CT冠状动脉血管成像294例次，现报道如下。
1 资料与方法
1.1 一般资料
方便选取的该组294例患者，其中男154例、女140例，年龄34～78岁，平均(53.4±10.4)岁。疾病诊断184例，疾病随访74例，风险评估指导治疗26例。诊断冠心病患者109例，其中男60例、女49例，年龄(57.4±8.4)岁，校正年龄、性别其中无冠心病对象41例，其中25例、女16例，年龄(56.7±9.2)岁。两组年龄、性别差异无统计学意义(P>0.05)。, http://www.100md.com(黄夏莲)
[关键词] 冠状动脉；血管成像；多层螺旋CT；诊断
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2017)10(b)-0185-03
[Abstract] Objective This paper tries to analyze the multi-slice spiral CT coronary angiography technique and its clinical application value and to summarize the clinical experience. Methods From January 2015 to February 2017， 294 cases of CT coronary artery angiography were carried out. The imaging quality， coronary artery segment display rate， various types of heart disease were convenient selected. The adverse events rate of heart disease diagnosed by CT of high risk subjects and low risk subjects was compared. Results The satisfaction rate of the imaging quality was 100.00%， coronary vascular segments display accounted for 89.41%(3 943/15×294). In the diagnosis of coronary heart disease， myocardial bridge， left ventricular dysfunction， congenital coronary vascular development abnormality， the coincidence rate of coronary angiography and CT diagnosis was 100.00%(24/24). CT assessment of high risk patients with surgery or adverse cardiac events was higher than that of low risk subjects， the difference was statistically significant(P<0.05). During the CT examination， 2 cases had adverse reactions. Conclusion Multi-slice spiral CT coronary angiography technology can be used in disease diagnosis， risk prediction， treatment and selection of guidance， evaluation of curative effect， but there are also some bad reactions， such as unclear display of part of coronary section.
[Key words] Coronary artery； Angiography； Multi-slice spiral CT； Diagnosis
冠脉病变是一种常见病，以血管造影成像为诊断“金标准”，但这种技术具有创伤性，患者接受率低，适应症狭窄。在我国，因高血压等疾病发生率显著上升，人口老龄化，冠脉病变开始成为常见病、多发病，如冠心病发病率已达到1%～2%[1]。以冠心病为代表的冠脉疾病，是心律失常、心力衰竭、急性冠脉综合症等重要危险因素。参照美国，可以预见冠脉病变将成为我国居民死亡的主要病因之一。多排螺旋CT冠状动脉血管成像是诊断冠脉病变的重要技术，相较于“金标准”，有创伤性小、更为安全等优势。2015年1月—2017年2月，医院共开展冠脉螺旋CT冠状动脉血管成像294例次，现报道如下。
1 资料与方法
1.1 一般资料
方便选取的该组294例患者，其中男154例、女140例，年龄34～78岁，平均(53.4±10.4)岁。疾病诊断184例，疾病随访74例，风险评估指导治疗26例。诊断冠心病患者109例，其中男60例、女49例，年龄(57.4±8.4)岁，校正年龄、性别其中无冠心病对象41例，其中25例、女16例，年龄(56.7±9.2)岁。两组年龄、性别差异无统计学意义(P>0.05)。, http://www.100md.com(黄夏莲)