探讨64层螺旋CT对冠状动脉畸形的诊断价值
毕业论文2.22W
【摘要】 【目的】 评价64层螺旋CT在诊断冠状动脉畸形方面的临床应用价值。【方法】 对38例冠状动脉畸形的64层螺旋CT资料进行回顾性分析,将原始数据传至工作站,行多平面重建(MPR)、容积再现(VR)、最大密度投影(MIP)和血管探针等后处理。10例同时行传统冠脉造影(CAG),3例行手术。【结果】 38例患者畸形血管在CT图像上得以清晰显示。冠状动脉开口起源异常6例,单支冠状动脉畸形2例,冠状动脉瘘2例,冠状动脉肌桥20例,副冠状动脉8例,10例CAG结果9例与CT一致,1例右侧冠状动脉高位开口CAG误诊为缺如,3例手术结果与CT一致。【结论】 64层螺旋CT冠状动脉造影清晰显示了畸形血管的起源、行程、终止及腔内情况,可作为冠状动脉畸形首选的检查方法。
【关键词】 体层摄影术,X线计算机; 血管造影术; 冠状动脉; 血管畸形
Abstract: 【Objective】 To evaluate the clinical application of 64-slice spiral computed tomography in the diagnosis of coronary artery anomalies (CAAs). 【Methods】 The 64-slice spiral computed tomography images of 38 patients with CAAs were retrospectively analyzed. The raw data were transferred to the work station(vitrea@2 version 3.7.0), and then multi-planar reconstruction (MPR), volume render (VR), maximum intensity projection (MIP),curved-planar reconstruction (CPR) and blood vessel probe were performed. Ten patients were performed conventional coronary artery angiography (CAG) and 3 patients were performed surgery. 【Results】 The origin and course of anomalous CA in 38 patients were displayed clearly by 64-slice spiral computed tomography. Six patients were anomalous origin of CA trunk; 2 were single CA anomaly; 2 were the branch of RCA fistula (1 to the pulmonary artery, 1 to the right atrium); 20 were mural coronary artery; 8 were para coronary artery, which is the branch of arterial conus origins directly from the right coronary sinus. Nine results of the 10 CAG were accordant with CT, 1 high origin of RCA was mistaken for congenital absence in CAG. Three operation results were accordant with CT. 【Conclusion】 The 64-slice spiral computed tomography displayed the origins, course and the condition of intralumens of CA clearly. It’s better than CAG on some degree. 64-slice spiral computed tomography could be used as the first choose of imaging tools for suspected CAAs.
Key words:tomography, X-ray computed; angiography; coronary artery; vessel anomalies
冠状动脉(简称冠脉)畸形是指冠脉起源、走行及终止的异常。冠脉畸形可以引起心肌缺血,心功能不全,甚至猝死;早期发现至为重要。传统冠脉造影一直被以为诊断冠脉畸形的'金标准,但由于国内接受此项检查的患者较少,畸形的发现率不高[1,2]。多层螺旋CT(multi-slice spiral computed tomography,MSCT)及其后处理技术的发展,能清晰显示畸形血管的起源、形程及终止,得到越来越多的重视[3]。64层螺旋CT作为目前最先进的MSCT,以其更快的扫描速度和更薄的扫描层厚而获得更加清晰的图像。冠脉畸形表现多样,本文报道一组冠脉畸形的64层螺旋CT表现,并评价其在诊断冠脉畸形方面的价值。
1 材料与方法
1.1 临床资料
2005年10月至2006年7月在我院共行64层螺旋CT冠脉造影510例,对其中的38例冠状动脉畸形进行回顾性分析,患者年龄9~71岁,平均51.6岁;其中男27例,女11例。2例小儿为复杂先天性心脏病;余36例成人1例体检发现心动过缓,2例心律不齐,余均系胸闷、气促、心悸查因。
【关键词】 体层摄影术,X线计算机; 血管造影术; 冠状动脉; 血管畸形
Abstract: 【Objective】 To evaluate the clinical application of 64-slice spiral computed tomography in the diagnosis of coronary artery anomalies (CAAs). 【Methods】 The 64-slice spiral computed tomography images of 38 patients with CAAs were retrospectively analyzed. The raw data were transferred to the work station(vitrea@2 version 3.7.0), and then multi-planar reconstruction (MPR), volume render (VR), maximum intensity projection (MIP),curved-planar reconstruction (CPR) and blood vessel probe were performed. Ten patients were performed conventional coronary artery angiography (CAG) and 3 patients were performed surgery. 【Results】 The origin and course of anomalous CA in 38 patients were displayed clearly by 64-slice spiral computed tomography. Six patients were anomalous origin of CA trunk; 2 were single CA anomaly; 2 were the branch of RCA fistula (1 to the pulmonary artery, 1 to the right atrium); 20 were mural coronary artery; 8 were para coronary artery, which is the branch of arterial conus origins directly from the right coronary sinus. Nine results of the 10 CAG were accordant with CT, 1 high origin of RCA was mistaken for congenital absence in CAG. Three operation results were accordant with CT. 【Conclusion】 The 64-slice spiral computed tomography displayed the origins, course and the condition of intralumens of CA clearly. It’s better than CAG on some degree. 64-slice spiral computed tomography could be used as the first choose of imaging tools for suspected CAAs.
Key words:tomography, X-ray computed; angiography; coronary artery; vessel anomalies
冠状动脉(简称冠脉)畸形是指冠脉起源、走行及终止的异常。冠脉畸形可以引起心肌缺血,心功能不全,甚至猝死;早期发现至为重要。传统冠脉造影一直被以为诊断冠脉畸形的'金标准,但由于国内接受此项检查的患者较少,畸形的发现率不高[1,2]。多层螺旋CT(multi-slice spiral computed tomography,MSCT)及其后处理技术的发展,能清晰显示畸形血管的起源、形程及终止,得到越来越多的重视[3]。64层螺旋CT作为目前最先进的MSCT,以其更快的扫描速度和更薄的扫描层厚而获得更加清晰的图像。冠脉畸形表现多样,本文报道一组冠脉畸形的64层螺旋CT表现,并评价其在诊断冠脉畸形方面的价值。
1 材料与方法
1.1 临床资料
2005年10月至2006年7月在我院共行64层螺旋CT冠脉造影510例,对其中的38例冠状动脉畸形进行回顾性分析,患者年龄9~71岁,平均51.6岁;其中男27例,女11例。2例小儿为复杂先天性心脏病;余36例成人1例体检发现心动过缓,2例心律不齐,余均系胸闷、气促、心悸查因。
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