摘要
目的评价320排动态容积CT（东芝Aquilion One动态容积CT）用于冠状动脉成像的初步应用结果。方法自2008年11月至2009年1月，采用320排CT对广州中山大学附属第三医院临床拟诊为冠心病的180例连续性病例进行心电门控宽探测器平台下非螺旋全器官容积增强扫描，其中14例有冠状动脉造影，与冠状动脉CTA作对照。通过横轴位、容积再现（VR）、最大密度投影（MIP）、多平面重建图像（MPR）和曲面重建（CPR）等方法，重点分析冠状动脉成像质量和计算诊断冠状动脉狭窄I〉50％的敏感性、特异性、阳性预测价值及阴性预测价值。结果冠脉成像质量4分145例（80．56％），平均心率为63（52～85）次／min；3分25例（13．89％），平均心率为78（77～98）7欠／min；2分8例（4．44％），平均心率为85次／min；1分2例（1．11％），平均心率为96次／min。全部病例无阶梯伪影。CTA发现40个节段狭窄≥50％，常规X线冠状动脉造影（CAG）发现37个节段狭窄≥50％。320排CT冠状动脉成像诊断冠状动脉狭窄≥50％的敏感性、特异性、阳性预测价值、阴性预测价值分别为94．59％、94．80％、87．50％、98．82％。结论宽探测器平台下非螺旋扫描模式的320排CT冠状动脉成像伪影少，图像质量高，对诊断冠状动脉狭窄有较高的敏感性和特异性。
Objective To evaluate initial application of coronary images from 320-slice dynamic volume MDCT （Toshiba Aqnilion One dynamic volume MDCT）. Methods 180 consecutive patients with suspected coronary artery disease were studied by ECG-gated 320-slice dynamic volume MDCT with non- helical scanning mode in our hospital from November, 2008 to January, 2009. 14 patients also underwent conventional coronary angiography. Images were retrospectively reconstructed under volume rendering technology, maximum intensity projection, muhiplanar reconstruction and curved planar reformation. Image quality was analyzed in axial 320-detector row images through the mid-RCA. Sensitivity, specificity, positive and negative predictive value of ≥ 50% stenosis were calculated. Results 145 （80. 56% ） cases had excellent images at average heart rate of 63 bpm. 25 （ 13.89% ） cases had good images at average heart rate of 78 bpm. 8 （4. 44% ） cases had acceptable images at average heart rate of 85 bpm. 2 （1.11%） cases had unevaluable images at average heart rate of 96 bpm. No stair-step artifact was found. 40 segments with ≥ 50% stenosis were shown in CTA, while 37 segment in CAG. The sensitivity , specificity , positive and negative predictive value of the 320 slice DMCT in detecting coronary artery stenosis ≥50% were 94. 59% , 94. 80%, 87. 50% and 98. 82% respectively. Conclusion Coronary images from 320-slice dynamic volume MDCT with wide area detector and non-helical scanning mode have excellent quality and less artifacts. 320-slice coronary CT angiography provides high sensitivity and specificity in detecting coronary artery stenosis.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2010年第7期478-481,共4页
National Medical Journal of China
