Abstract
目的 评价多层螺旋CT冠状动脉造影(MSCTA)在冠心病中的应用价值.方法对40例冠心病患者(35例拟诊冠心病,5例冠状动脉支架或搭桥术后患者)进行了心电门控螺旋CT(MSCT)增强扫描,所得数据传到工作站进行三维重建,并与冠状动脉造影结果相对照.结果 40例患者中对160支冠状动脉(简称冠脉)进行了MSCT三维重建, 35例拟诊者中4例MSCTA和DSA排除了冠脉疾病;31例124支冠脉中,MSCTA对于显示近中段≥50%的狭窄有一定的准确性(敏感性81.8%,特异性90.1%),不能显示轻度狭窄病变、远端或细小分支病变;可以发现并判断粥样硬化斑块的类型,显示斑块的形态及引起狭窄的程度.钙化斑块特别是钙化范围广者可引起管腔轻度狭窄(冠状动脉腔径狭窄＜50%),非钙化斑块则引起较明显的狭窄(冠状动脉腔径狭窄≥50%).4例冠状动脉支架和1 例冠状动脉搭桥术后均可清晰显示支架和血管桥的位置及远端血流情况.结论MSCTA是有效可靠的冠心病诊断方法,对病变血管管腔狭窄、粥样硬化斑块的评价有一定的应用价值.它作为一种非创伤性检查方法,可替代DSA用于易碎软斑块的早期检查。
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