摘要
目的定量评估64层螺旋 CT(MSCT)与 DSA 2种成像方法显示冠状动脉狭窄及支架内再狭窄的能力和可靠性。方法应用心脏动态体模,设定心率为0、50、70、90次/min,对内径3 mm的模拟冠状动脉(内设25%、50%、75%3段狭窄)及内径4 mm 的模拟带支架冠状动脉(支架段内设50%、75%2段狭窄)分别进行 MSCT 与 DSA 成像,将 MSCT 与 DSA 对应数据进行分析。结果(1)MSCT 对25%、50%、75%3段狭窄的平均测量值为(30.0±1.4)%、(49.5±1.3)%、(72.9±3.9)%(P 值分别为0.005、0.531、0.369);DSA 分别为(24.8±2.0)%、(48.2±2.1)%、(75.3±2.4)%(P 值分别为0.883、0.180、0.796)。(2)MSCT 图像伪影随心率增快而增加,心率≥170次/min 影响变明显;DSA 不受心率影响,所有心率下都可清晰地显示狭窄程度,无伪影。(3)MSCT 与 DSA 测量血管狭窄程度有较好的相关性(r=0.995,P=0.000)。(4)MSCT 可同时显示支架及支架内狭窄,但显示支架内狭窄能力有限,对50%狭窄分别显示为(46.4±4.5)%(心率为0)和(43.6±5.7)%(心率为50次/min),与标准值(50%)相比,差异有统计学意义(P<0.05)。DSA 可清晰显示支架内狭窄,但不能很好显示支架形态。结论 (1)MSCT 与 DSA 评价冠状动脉狭窄结果可靠,MSCT 受心率的影响大,时间分辨率有待提高,作为排除性诊断有很高的临床应用价值;MSCT 对于支架内再狭窄的判断尚有一定局限性,但在管径较粗和低心率条件下评价支架内再狭窄有一定价值。
Objective To evaluate the diagnostic accuracy and reliability for coronary artery stenosis and in-stent restenosis detection using 64-slice spiral computed tomography（ multislice CT, MSCT） angiography and digital subtraction angiography （DSA）. Methods A pulsating cardiac phantom with two simulated coronary arteries was scanned on a 64- slice CT scanner and underwent DSA at static state, at 4 different sinus rhythms of 0, 50, 70, and 90 beats per minute （bpm）. One simulated artery was 3 mm in lumen diameter with 3 segments of 25%, 50%, and 75% stenoses. A stent with 2 segments of 50% and 75% stenoses was placed into the other artery with 4mm in lumen diameter. Images from MSCT were analyzed and compared with those from DSA. Results （ 1 ） The mean values of the 25% , 50%, and 75% stenoses measured with MSCT were （ 30. 0 ± 1.4 ） %, （49.5 ± 1.3 ） %, and （ 72. 9 ± 3.9 ） %, respectively （P values were 0. 005, 0. 531, and 0. 369 respectively）. The mean values of the 25%, 50%, and 75% stenoses measured with DSA were （ 24. 8 ± 2.0 ） %, （ 48. 2 ± 2. 1 ） %, （ 75.3 ± 2. 4 ） % respectively （P values were 0. 883, 0. 180, and 0. 796, respectively）. （2） MSCT was susceptible to heart rate, with artifact increasing as heart rate increasing, especially when the heart rate were ≥70 bpm. （3） There was a good correlation between 64-slice MSCT and DSA（r =0. 995,P =0. 000）. （4） 64-slice MSCT could show the stent and in- stent restenosis simutaneously. Its capability to depict in-stent restenosis was limited. The depiction rate of 50% in- stent restenosis were （46. 4 ±4.5）% （0 bpm） and （43.6 ±5.7）% （50 bpm） respectively（P 〈 0. 05 ）. DSA could depict the in-stent stenosis but could not show the morphology of the stent. Conclusion 64-slice MSCT is reliable in detecting coronary artery stenosis. MSCT has clinical application value due to its non-invasive nature. Even though its capability is somewhat limited in depicting in-stent restenosis, MSCT is promising in the cases when vessel caliber is relatively large and heart rate is relatively low.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2007年第10期1036-1039,共4页
Chinese Journal of Radiology
