摘要
目的研究16排螺旋CT一次扫描同时完成冠状动脉、主动脉和肺动脉CT血管成像(CTA)检查对鉴别高危胸痛的价值。方法2005年12月至2007年6月在笔者医院住院及急诊胸痛患者38例,其中男性21例,女性17例,年龄47～76岁。临床症状为胸痛、胸闷、憋气、心前区不适等。检查时,心率要求70次/分以下,心率快者给予含服倍他乐克,心率符合要求后扫描。应用TOSHIBA AQUILION 16排螺旋CT,先行胸部CT平扫,然后利用回顾性心电门控技术行胸部CT增强扫描。应用VR、CPR等方法观察冠状动脉情况,应用电影显示、VR、MIP等方式观察肺动脉情况,应用MPR、CPR、VR等方式重建并观察主动脉情况。结果38例患者一次检查均可清晰显示肺动脉段以上分支、胸主动脉及冠状动脉左右主干及主要分支。共发现冠状动脉狭窄34例,肺动脉栓塞4例,主动脉夹层2例。从冠状动脉各支显示情况来看,显示最清晰的是左主干、左前降支近段、左回旋支近端,其次为右冠状动脉,再次为各主干分支,38例患者冠状动脉共显示247支,其中发现狭窄47支。肺动脉4、5、6级分支应用MIP、VR及电影显示均可清晰观察,共发现肺动脉栓塞4例,2例为一侧肺动脉干栓塞,其余均为两下肺动脉4、5级分支多发栓塞。结论16排螺旋CT一次动脉期增强扫描显示肺动脉、胸主动脉及冠状动脉,对胸痛病因的诊断及鉴别诊断效果可靠。
Objective To study the diagnosis and differential diagnosis value of 16-slice spiral CT for coronary artery,pulmonary artery and aorta in patients with high-risk chest pain together. Methods During December 2005 to June 2007,38 patients in hospital and emergency （male 21 and female 17, aged 47 - 76 years ） with chest pain, chest distress and precardial discomfort were enrolled. Heart rate was requested below 70,and patients with higher heart rates were demanded with Betaloc sublingually. Patients were underwent chest plain scanning first,and then enhanced scanning by TOSHIBA AQUILION 16-slice spiral CT. Coronary artery was observed with application of VR and CPR methods;Pulmonary artery was examined with application of cinema display ,VR and MIP methods;Aorta was reconstructed and observed with application of MPR, CPR and VR methods. Results Higher segmental pulmonary artery,thoracic artery,main （left and right） coronary artery and its main branches were clearly shown. There were 34 cases with coronary artery stenosis,4 cases with pulmonary artery embolism, and 2 cases with aortic dissection,of which one was combined with coronary artery stenosis. Among the coronary artery branches,left main coronary artery and proximal segment of the left anterior descending coronary artery and left anterior circumflex artery were best shown ; Right coronary artery was better;Other main branches were good too;Two hundred and forty-seven branches in 38 cases were clearly shown, of which 47 branches were artery stenosis. Grade Ⅳ - Ⅴ branches of pulmonary artery could be clearly observed with application of MIP, VR and cinema display methods and even grade Ⅵ could be clearly shown. There were 4 cases with pulmonary artery embolism,of which 2 cases were one side pulmonary trunk embolism and others were multiple embolism in grade Ⅳ - Ⅴ branches of two descending pulmonary artery. Conclusion Arterial phase dynamic enhanced 16-slice spiral CT scanning shows pulmonary artery, thoracic artery and coronary artery, which is very important for diagnosing and differentially diagnosing the cause of chest pain.
出处
《生物医学工程与临床》
CAS
2007年第6期467-471,共5页
Biomedical Engineering and Clinical Medicine
