64层螺旋CT冠状动脉成像探针技术临床应用评价

目的 评价64层螺旋CT（64SCT）冠状动脉探针技术成像的图像质量及其在诊断冠状动脉疾病中的临床应用价值.方法 对98例临床初诊疑为冠心病（CHD）且既往无冠脉成形术和搭桥术史的患者行心脏冠状动脉CT成像（CTA）,采用前瞻性心电门控技术取得轴位图像,对所有冠状动脉主要分支进行探针技术重建,计算冠状动脉管腔狭窄程度,并与冠状动脉造影（CAG）结果进行比较分析.结果 1）64层螺旋CT冠状动脉成像探针技术测量的准确性（是否狭窄、狭窄程度）高;2）64层螺旋CT具有较高的时间和空间分辨率,重建冠状动脉并采用探针技术,对管腔直径〉1.5平mm、狭窄程度〉50%的病变段,诊断敏感性为87.97%,特异性为92.23%,阳性预测值为93.6%,阴性预测值为85.6%;3）64层螺旋CT冠状动脉成像探针技术显示软斑块及钙化性硬斑块准确率分别为87.6%及47.6%.结论 64层螺旋CT冠状动脉成像探针技术可以参照容积再现图像（VR）立体直观地定位病变的空间位置,并对照曲面重建图像（CPR）对病变的管壁情况、管腔狭窄情况准确地判断,该种整合多种手段于一体的后处理成像方法对冠状动脉狭窄诊断的准确性、直观性都有非常大的优势.

Clinical Application of 64-Slice Spiral CT Coronary Artery Probe Technique

Objective To evaluate the image quality of 64-slice spiral CT coronary artery probe technique and its clinical value in the diagnosis of coronary artery disease. Methods Ninety-eight suspected coronary heart disease （CHD） patients without a history of coronary angioplasty or coronary artery bypass graft surgery underwent coronary CT angiography （CTA）. Prospective ECG gating technique was used to obtain the axial images. Probe technique was used to recon- struct all the main coronary branches and to calculate the degree of coronary artery stenosis. The results were compared with coronary angiography. Results The 64 slice spiral CT coronary artery imaging probe technique provided a high accuracy for the measurement of coronary artery stenosis. Moreover, 64 slice spiral CT had spatial and temporal distinguishability. Coronary artery reconstruction and application of probe technique resulted in a diagnosis sensibility of 87.97%, a specificity of 92. 23%, a positive predictive value of 93.6% and a negative predictive value of 85.6% in the lesion segment with lumen diameter 〉1.5 mm and stenosis degree 〉50%. In addition,the accuracy of 64-slice spiral CT coronary artery imaging probe technique was 87.6% and 47.6% for soft plaque and calcified plaque,respectively. Conclusion The 64-slice spiral CT coronary artery imaging probe technique can stereoscopically locate the position of lesions in reference to volume rendering. Furthermore,it can accurately estimate vascular wall and luminal stenosis by comparing to the curved planar reformation. The post-processing method is endowed with great advantages in the accuracy and intuitiveness of diagnosis of coronary artery stenosis.