摘要
目的分析不同影像检查在诊断及治疗冠心病合并大动脉狭窄中的作用及其优缺点和最佳选择。方法对52例经冠状动脉造影确诊的冠心病患者,同时用彩色多普勒超声(CDUS)、CT血管造影(CTA)、磁共振血管造影(MRA)以及数字化动脉血管造影(DSA)来分析患者合并大动脉狭窄的发生率;并分别经股动脉及肱动脉植入冠状动脉及大动脉支架。结果4种检查方法显示:52例患者共发现冠状动脉狭窄103处。外周大动脉狭窄67处,其中CDUS发现23处,发现率34.3%;MRA/CTA发现57处,发现率85.1%;DSA发现62处,发现率92.5%。CDUS时间短、花费低,对颈动脉近端的狭窄敏感性较高;MRA对脑动脉及颈动脉特异性好;CTA对肾动脉及胸腹主动脉等搏动大的血管显示较清晰;DSA诊断明确率高,并能与介入手术结合进行,但时间长、费用高。结论CDUS简单易行,可作为普查及术后复查;CTA及MRA可作为术前检查并建立三维图像,了解狭窄程度及与周围组织的关系;DSA费用较高,且有一定的风险,但在冠心病及大动脉狭窄的诊断及支架治疗中是必不可少的。
Objective To analyze the effect, advantages and shortcomings of different screenage examination on the diagnosis and treatment for coronary heart disease complicated with main arterial stenosis. Methods 52 patients with coronary heart disease diagnosed by coronary artery contrast examination were detected by color Doppler ul- trasound（CDUS）, computed tomography angiography（CTA）, magnetic resonance angiography （ MRA ） and digital subtraction angiograoy（DSA）to analyze the incidence of main arterial stenosis, and they were implanted the coronary artery and main artery stent via femoral and brachial artery. Results The four examination methods showed that among 52 patients 103 stenotic places were found in coronary artery and 67 stenotic places in main artery. In main artery stenosis 23（34.3 %） places were found by CDUS, 57（85.1%） places by MRMETA, 62（92.5 %） places by DSA. The CDUS was easy to be done, with lower cost; MRA was especially gnod for carotid and cerebral artery; DSA was the best for diagnosis and differential diagnosis, although it cost more money. Conclusion The four methods have their advantages themselves, which can compensate each other, CDUS can be used for extensive survey and follow-up, CTA and MRA can be used for preoperative examination and built three-dimension graphics for knowing the relationship between the stenosis and surrounding tissue, but the DSA is necessary for the diagnosis and stent treatment in coronary heart disease and main arterial stenosis.
出处
《疑难病杂志》
CAS
2008年第3期139-142,F0003,共5页
Chinese Journal of Difficult and Complicated Cases
关键词
冠心病
狭窄
大动脉
检查
影像学
Coronary heart disease
Stenosis, main artery
Examination, iconography
