摘要
目的 探讨多层螺旋CT回顾性心电门控冠状动脉重建的最佳R R时相 ,评价多层螺旋CT冠状动脉重建的临床应用价值。方法 对 2 0例拟诊冠心病患者多层螺旋CT扫描后 ,利用回顾性心电门控重建出 37 5 %、5 0 0 %、6 2 5 %、75 0 %R R时相的横断面图像。然后进行冠状动脉容积重建及仿真血管内窥镜重建 ,分析不同R R时相各支冠状动脉的显示情况。以选择性冠状动脉造影结果为对照 ,评价多层螺旋CT冠状动脉重建图像诊断冠状动脉≥ 5 0 %管径狭窄的临床应用价值。结果 左前降支、左回旋支和右冠状动脉重建的最佳时相为 5 0 0 %和 6 2 5 %R R时相 ;多层螺旋CT冠状动脉重建图像诊断冠状动脉≥ 5 0 %管径狭窄的敏感度、特异度、阳性预测值、阴性预测值和诊断正确率分别为 91 7%、83 3%、2 8 2 %、99 3%和 83 9%。结论 选择回顾性心电门控最佳R R时相重建冠状动脉可以最大限度减轻心脏运动伪影 ,提高图像质量 ;多层螺旋CT冠状动脉重建图像具有很高的敏感度和阴性预测值 ,可以作为选择性冠状动脉造影前的筛选检查。
Objective To investigate the optimal R-R phase of retrospectively electrocardiographically(ECG)-gated image reconstruction for multi-slice spiral CT (MSCT) coronary reconstruction and it's clinical application. Methods A total of 20 patients with known or suspected coronary artery disease (CAD) were detected with retrospectively ECG-gated MSCT (4×1.3 mm cross-section,500-ms rotation,pitch 0.375) during a single breath hold. Tomographic source images were reconstructed at the starting points of 37.5%,50.0%,62.5%,and 75.0% R-R intervals,followed by volume rendering (VR) and virtual vascular endoscopy (VVE) for reconstruction of coronary artery. The quality of images reconstructed with different R-R phases was analyzed in terms of artifacts and visibility. Selective coronary angiography (SCA) was used for reference. Results The left anterior descending artery,the left circumflex artery,and the right coronary artery were all best visualized at 50.0% and 62.5% R-R phases. The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy for the detection of ≥50% stenosis with the optimal R-R phase imagines of MSCT were 91.7%,83.3%,28.2%,99.3%,and 83.9%,respectively. Conclusion The optimal R-R phase of retrospectively ECG-gated reconstruction images can decrease the artifacts of cardiac motion and improve the reconstructive image quality of coronary arteries. With high sensitivity and negative predictive value,MSCT coronary reconstruction is considered as a good screening test before SCA.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2004年第2期178-183,共6页
Chinese Journal of Radiology
