摘要
目的探讨利用256层螺旋CT冠状动脉成像进行冠心病大范围筛查及复查的可行性及临床价值。方法使用飞利浦256层螺旋CT对临床拟诊冠心病及已确诊冠心病的复查患者共2 200例进行冠脉CTA扫描,对图像质量进行评判分级,并分析影响成像质量的可能因素。结果 2 200例中拟诊冠脉粥样硬化性心脏病2 000例(A组),术后复查200例(B组),其中冠脉搭桥术后复查16例,支架置入术后复查184例。2 200例扫描总体成功率为98.0%,图像质量优、良、中、差、分别为41.6%、40.3%、16.1%、2.0%。A组成功率98.2%,图像质量方面优846例,占42.3%,良797例,占39.85%,中321例,占16.05%,差36例,占1.8%。B组成功率96.5%,图像质量方面优70例,占35.0%,良89例,占44.5%,中34例,占17.0%,差7例,占3.5%。呼吸、心率、钙化、肥胖对图像质量的不良影响分别为53.8%、20.9%、13.4%、11.9%。结论呼吸屏气质量及情绪稳定是影响成像质量的首要因素,扫描前准备工作是否充分到位是扫描成败的关键。256层螺旋CT冠脉CTA绝大部分病例扫描结果可以满足临床诊断需要,是冠心病大范围筛查和治疗后复查的有效方法。
Objective To evaluate the feasibility and clinical value of non-invasive 256-slice spiral CT angiography （CTA） in the large-scale population screening and patients reviewing. Methods 2 200 patients who were suspected or confirmed the diagnosis of coronary heart disease underwent 256-sliee spiral CTA examination. The image quality was evaluated and graded, also the possible influencing factors were analyzed. Results Of all 2 200 cases, there were 2 000 ca ses （group A） with suspected coronary atheroselerotic heart diseases and 200 reviewed cases （group B） after surgery of which 16 cases with coronary artery bypass surgery and 184 cases with stent implantation. For 2 200 cases, the overall success rate was 98.0 %, image quality as excellent, good, fair and poor were 41.6 %, 40.3 %, 16.1% and 2.0 % respec tively. For group A, success rate was 98.2%, image quality as excellent in 846 cases, accounting for 42.3%, good in 797 cases, accounting for 39.85%, fair in 321 cases, accounting for 16.05%, and poor in 36 cases, accounting for 1.8%. For group B, success rate was 96.5%, excellent in 70 cases （35.0%）, good in 89 cases （44.5%）, fair in 34 cases （17.0%）, and poor in 7 cases （3. 5%）. The influences of breathing, heart rate, calcification and obesity on image quality were 53.8%, 20.9%, 13.4%, 11.9% respectively. Conclusion The quality of breath holding and emotional stability were the primary factors that affect the image quality, and well preparation before scanning is the key to success. The coronary CTA imaging technology with 256-slice CT could meet the clinical needs and can be used for screening, diagnosing and reassessing of coronary heart disease in the large-scale population.
出处
《医学影像学杂志》
2013年第1期52-55,共4页
Journal of Medical Imaging
