【摘要】 目的:比较多层螺旋CT冠状动脉造影时各种重建技术评价冠状动脉疾病的准确性。材料和方法:20例患者做16层螺旋CT冠状动脉造影(回顾性心电门控、0.42s螺旋扫描),进行容积再现技术(VRT)、最大密度投影(MIP)、曲面重建(CPR)、仿真内窥镜(CTVE)等图像后处理,并与常规冠状动脉造影对照。结果:在20例患者的136节段(血管直径≥2mm)中,CT图像能满足诊断要求的有122节段(89.7%)。对于CT图像能满足诊断要求的冠状动脉节段,在横断位图像显示中度或中度以上狭窄的敏感度和特异度分别为81.2%和94.4%,CTVE为71.8%和84.4%,MIP为68.7%和84.4%,CPR为65.6%和87.7%,VRT为65.6%和74.4%。将5种重建技术结合后显示中度或中度以上狭窄的敏感度和特异度分别为87.5%和96.6%。结论:横断面图像显示中度或中度以上狭窄的敏感度和特异度最高。在冠状动脉中高度狭窄的诊断上,16层螺旋CT冠状动脉造影是一种有效的无创性诊断方法。更多还原

【Abstract】 Objective: To evaluate the accuracy of different reformation techniques in assessing coronary artery disease. Methods: Twenty patients were studied by 16-slice spiral CT(retrospective ECG-gating; 0.42s rotation). Each patient’s CT data set was evaluated using transverse scanning, volume rendering technique, maximum intensity projection, curved multiplanar reformations and CT virtual endoscopic reformation. The results were compared with coronary artery angiography. Results: In the 136 coronary artery segments(vessel diameter≥2mm) of 20 patients, 122 were judged to be diagnosed by CT(89.7%). Transverse scanning showed the highest sensitivity and specificity for detection of stenosis≥50%(81.2% and 94.4%), followed by virtual endoscopy(71.8% and 84.4%), maximum intensity projection(68.7% and 84.4%), curved multiplanar reformations(65.6% and 87.7%), volume rendering(65.6% and 74.4%). Combined with all techniques, the sensitivity and specificity for the detection of stenosis≥50% were 87.5% and 96.6%, respectively. Conclusion: Transverse scanning showed the highest sensitivity and specificity for the detection of stenosis≥50%. 16-slice spiral CT could be used as a noninvasive method for the assessment of significant coronary artery stenosis with high accuracy.更多还原