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目的:探讨64排螺旋CT在冠状动脉旁路移植患者术后随访中的价值。方法:对52例接受冠状动脉旁路移植患者作螺旋CT检查,进行血管重建,对部分患者同期进行冠状动脉造影检查,结合临床症状对螺旋CT成像结果进行分析。结果:52例患者均成功完成了冠状动脉螺旋CT检查,共有187支桥血管成像,其中乳内动脉移植血管50支,静脉移植血管129支,桡动脉移植血管8支。50支乳内动脉移植血管中,6支有不同程度狭窄;129支静脉移植血管中,48支有不同程度狭窄;8支桡动脉桥中2支有不同程度狭窄。本组患者中有28例患者同期作了冠状动脉造影,共检出105支移植血管血管,造影结果与CT检查结果基本相符,螺旋CT检查假阳性率为4.4%,假阴性率为2.7%。检出有移植血管血管病变的27例患者中,22例有临床症状;另有3例有症状的患者,螺旋CT检查未发现有异常。结论:作为一种微创伤检查方法,64排螺旋CT是冠状动脉旁路移植患者术后随访的理想的方法。
Objective: To investigate the value of 64-slice spiral CT in the follow-up of patients undergoing coronary artery bypass grafting. Methods: Fifty-two patients undergoing coronary artery bypass grafting underwent spiral CT examination and revascularization. Coronary angiography was performed on some patients in the same period, and the results of spiral CT imaging were analyzed in combination with clinical symptoms. Results: All the 52 patients successfully completed the coronary spiral CT examination. A total of 187 vascular images were obtained. Among them, 50 were transplanted into the internal mammary artery, 129 were transplanted into the vein and 8 were transplanted into the radial artery. Among the 50 branches of internal mammary artery grafts, 6 had varying degrees of stenosis; 48 of 129 branches of vein grafts had varying degrees of stenosis; and 2 of 8 radial artery grafts had varying degrees of stenosis. In this group, 28 patients underwent coronary angiography at the same period, a total of 105 vessels were detected. The results of CT angiography were basically consistent with CT findings. The false positive rate was 4.4% and the false negative rate was 2.7%. Twenty-seven of the 27 patients with graft-versus-vessel vascular disease were clinically diagnosed; in three others with symptoms, no abnormalities were detected by spiral CT. Conclusion: As a minimally invasive method, 64-slice spiral CT is an ideal method for postoperative follow-up of patients undergoing coronary artery bypass grafting.