【摘要】 目的 探讨64层螺旋CT心脏双期扫描技术对诊断左房血栓及“血栓前状态”的应用价值。方法 34例疑有左房血栓的非瓣膜性心房颤动患者行64层螺旋CT心脏双期检查,第一期(心脏充盈期)扫描延迟时间以探测的循环时间为准,第二期(心脏延迟期)扫描延迟时间为90 s。13例患者同时做了经食管超声心动图检查。结果 第一期扫描显示左房低密度充盈缺损患者14例,其中6例第二期扫描仍表现为充盈缺损诊断为左心房血栓,8例第二期扫描时充盈缺损消失诊断为“血栓前状态”。其中2例左心房血栓和3例左房“血栓前状态”患者经食管超声心动图(TEE)检查结果与CT一致。另20例患者CT检查无异常,其中8例同时也做了TEE检查,结果未见异常。23例(67.6%)CT合并有冠状动脉病变,其中管腔狭窄达50%以上者10例(43.5%)。结论64层螺旋CT心脏双期扫描技术能够提高左房血栓及“血栓前状态”的正确诊断率,同时还能兼顾观察冠状动脉有无异常。更多还原

【Abstract】 Objective To evaluate the clinical value of 64—slice spiral computed tomography in the detection of left atrial thrombi and prothrombitic—state.Methods 34 patients with non—vascular atrial fibrillation underwent 64—slice spiral CT in dual—phases.The delayed time was timing bolus in the first phase(cardiac—filling time),and 90s in the second phase(cardiac—delayed time).Among these patients,13 patients also underwent transesophageal echocardiography(TEE).Results In the first phase,14patients showed filling—defects which were suspicious of thrombosis,after second phase,8 of these patients were diagnosed prothrombitic—state because of the disapperance of filling—defects which mean the blood stasis not real thrombosis,and 6 of these patients were diagnosed having thrombosis because the existence of filling—defects.Meanwhile,the results of TEE in 2 patients with left atrial thrombi and 3 patients with prothrombitic—state were consistent with CT.The other 20 patients including 8 cases undergone TEE showed normal in two phases.23(67.6%)patients with coronary diseases and 10 patients(43.5%) with coronary stenosis(over 50%) were also diagnosed by CT.Conclusion The dual—phases scan technique of 64—slice spiral CT can not only increase the accuracy of the diagnosis of left atrial thrombi and prothrombitic—state in patients,but also can detect the cardiac coronary problems.更多还原