【摘要】 目的探讨心率与多层螺旋 CT(MSCT)冠状动脉(简称冠脉)成像运动伪影的关系,及MSCT 冠脉成像的临床应用价值。方法对200例临床拟诊冠心病的患者行 MSCT 冠脉成像检查,分析扫描时心率与冠脉运动伪影的关系;其中37例同时行常规冠脉造影(简称冠造)检查,对比分析2种检查结果。结果扫描时心率≤55次/min、56～60次/min、61～65次/min、66～70次/min和>70次/min 组有运动伪影的冠脉节段分别占冠脉总数的0.1%(1/759)、1.1%(7/649)、2.5%(10/407)、42.6%(103/242)和75.5%(108/143);以常规冠造作为金标准,MSCT 诊断狭窄≥50%的敏感度、特异度、阳性预测值、阴性预测值分别为79.2%、96.0%、83.8%、94.6%。扫描时心率与冠脉运动伪影的数量显著相关(r=0.655,P=0.000)。结论 MSCT 能较准确诊断冠脉50%以上的狭窄,是无创性诊断冠脉狭窄的重要工具。更多还原

【Abstract】 Objective To investigate the influence of a patient’s heart rate on the presence of motion artifacts and on accuracy of stenosis detection on contrast-enhanced MSCT.Methods Two hundred patients with suspected coronary artery disease underwent the contrast-enhance MSCT,the main factors influencing imaging quality were analyzed.Thirty-seven patients underwent conventional selective coronary angiography in the same time.The results obtained from MSCT were compared.Results In the 5 groups (heart rate≤55 bpm,56—60 bpm,61—65 bpm,66—70 bpm,>70 bpm during scan),the proportion of segments that could not be assessed because of motion artifact were 0.1%(1/759),1.1%(7/649),2.5% (10/407),42.6%(103/242),and 75.5%(108/143),respectively.With conventional selective coronary angiography as the golden standard,the sensitivity,specificity,positive and negative prediction values to detect≥50% stenotic lesions in the assessable segments were 79.2%,96.0%,83.8%,and 94.6%,respectively.There was a significant correlation between the number of segments per patient not assessable because of motion artifact and heart rate during the scan(r=0.655,P=0.000).Conclusion MSCT is capable of achieving high accuracy for detection of coronary artery stenosis,and is a reliable technique to diagnose coronary artery disease.更多还原