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目的:探讨16层螺旋CT冠状动脉成像技术临床应用价值。方法:对45例临床诊断或可疑冠心病的住院患者行16层螺旋CT冠状动脉回顾性心电门控平扫及增强扫描。将增强扫描图像传送到Wizard图像工作站进行最大密度投影(MIP)、多平面重组(MPR)、曲面重组(CPR)、容积再现技术(VRT)及平带多平面重组(RMPR)。并将VRT及MIP重组像为参照,用平扫图像对冠状动脉各支段进行钙化积分。结果:左冠状动脉主干(LM)、左前降支近中段(LAD1、LAD2)、第一对角支(D1)、左回旋支(LCX)及右冠状动脉近段(RCA1)显示均45例(100%),左前降支远段(LAD3)23例(51%),第二对角支(D2)30例(67%),第三对角支(D3)24例(53%),第一左缘支(M1)36例(80%),第二缘支(M2)28例(62%),右冠状动脉中段(RCA2)41例(91%),右冠状动脉远段(RCA3)43例(96%)及后降支(PDA)34例(76%)。左冠状动脉主干钙化12例(27%),左前降支近中段钙化有29例(64%),左回旋支钙化例数22例(49%),右冠状动脉近中段钙化有24例(53%)。结论:16层螺旋CT可对冠状动脉进行钙化积分并准确显影,是冠状动脉粥样硬化疾病筛选和诊断的首选方法。
Objective: To investigate the clinical value of 16-slice spiral CT coronary angiography. Methods: Forty-five inpatients with clinical diagnosis or suspicious coronary heart disease underwent 16-slice spiral CT coronary angiography retrospective ECG gating and contrast-enhanced scanning. The enhanced scan images are sent to the Wizard Image Station for MIP, MPR, CPR, VRT, and RMPR. VRT and MIP recombinant images as a reference, with a plain scan of coronary branches of calcification. Results: The left coronary artery (LM), proximal left anterior descending artery (LAD1, LAD2), first diagonal branch (D1), left circumflex artery (LCX) and proximal right coronary artery (RCA1) 100%), 23 cases (51%) of left anterior descending branch (LAD3), 30 cases (67%) of second diagonal branch (D2) and 24 cases (53%) of third diagonal branch 36 cases (80%) of the left margin (M1), 28 (62%) of the second margin (M2), 41 (91%) of the middle right coronary artery (RCA2), RCA3 of the right coronary artery 43 (96%) and 34 (76%) patients with PDA. Left coronary artery calcification in 12 cases (27%), left anterior descending artery calcification in the middle of 29 cases (64%), left circumflex artery calcification in 22 cases (49%), right coronary proximal calcification in 24 cases (53 %). Conclusion: The 16-slice spiral CT can be used for the calcification of coronary artery and accurate imaging. It is the first choice for the screening and diagnosis of coronary atherosclerotic disease.