【摘要】 目的探讨16层螺旋CT(MSCT)冠状动脉成像的技术特点及诊断冠状动脉病变的准确性。方法67例临床拟诊为冠心病的患者行MSCT检查,分析扫描时心率、心电相位窗的选择及呼吸运动、扫描参数与冠脉图像质量的关系。其中13例同时行常规冠脉造影,对2种检查结果进行对比分析。结果心率≤55bpm/min、56～60bpm/min、61～65bpm/min、66～70bpm/min及大于70bpm/min冠状动脉的显示率分别为93.9%、94.4%、89.4%、68.7%和45.5%。心率对右冠状动脉(RCA)的影响最大,对左冠状动脉主干(LMA)的影响最小,呼吸运动对左冠的影响最大。70%、75%的心电相位窗对冠脉的显示率较好,分别为85.8%和88.4%。以常规冠造为标准,MSCT诊断狭窄≥50%狭窄总的敏感度为78.6%,特异度98.2%,阳性预测值84.6%,阴性预测值97.4%。结论运动伪影是影响图像质量的主要因素。MSCT能较准确的显示冠脉≥50%的狭窄,是冠脉疾病诊断和筛选的良好的无创性检查方法。更多还原

【Abstract】 Objective To explore the optimal imaging technique of coronary angiography with 16-slice spiral CT detected coronary artery lesions. Methods 67 patients with suspected coronary artery disease underwent the contrast-enhance MSCT. The relationship of the image quality with the heart rate during scan and R-R interval and respiratory motion and scan date were analyzed.13 patients underwent conventional selective coronary angiography,the results obtained from MSCT were compared. Results In 5 groups heart rate (heart rate≤55 bpm, 56～60bpm, 61～65bpm, 66～70 bpm, >70 bpm during scan), The`proportion of coronary artery can be showed were 93.9%, 94.4%, 89.4%、68.7% and 45.5 %. Heart rate mainly affected the display of RCA ,there were the least influence for LMA. Respiratory motion affected the display of left coronary were the greatest. Patients got optimal image quality in 70% or 75% R-R interval, the`proportion of segments were 85.8% and 88.4%. With conventional selective coronaryangiography as a standard, MSCT detected lesions with 50% or greater narrowing, the overall sensitivity, specificity,positive predictive value and negative predictive value were 78.6%, 98.2%, 84.6% and 97.4%, respectively. Conlusion Motion artifact is the main cause accounting for the failure of coronary angiography with MSCT. MSCT can correct diagnosis lesions with 50% or greater narrowing of coronary artery, and is a reliable technique to diagnose and filter coronary artery disease.更多还原