摘要
目的：探讨128层螺旋 CT 的血管成像技术在胸痛三联排查中的应用及价值。方法对73例以急性胸痛起病，临床高度怀疑急性冠状动脉综合征 ACS 、肺动脉栓塞或者主动脉夹层的患者，急诊行128层螺旋 CT血管成像，在原始数据基础上结合多平面重建、最大密度投影、容积再现及曲面重建技术，以不同角度显示冠状动脉、胸主动脉及肺动脉。其中26例行选择性冠脉造影，并与胸痛三联 CT 血管成像结果对照。结果73例患者均清晰显示胸主动脉、肺动静脉和肺部情况。其中4例心律不齐，部分冠脉节段显示不良，心电编辑软件矫正后，可满足诊断需要。其中3例屏气配合欠佳，部分节段冠状动脉显示欠佳，另行选择性冠状动脉造影，未见冠脉病变。其余各例均能清楚显示冠脉主干及各级分支。发现冠状动脉肌桥、斑块、狭窄和闭塞41例、203支，肺动脉栓塞10例，主动脉夹层9例，主动脉穿透性动脉硬化性溃疡4例，主动脉壁间血肿1例，非血管病变23例，正常9例。与选择性冠状动脉造影对照符合率100％。结论128层螺旋 CT 血管成像能一次性显示胸主动脉、冠状动脉与肺动脉，在胸痛三联排查中具有较高的临床应用价值。
Objective To explore the clinical application and value of 128‐slice spiral CT angiography in the triad of acute chest pain .Methods Acute chest pain in 73 patients were highly suspected to be caused by Acute coro‐nary syndrome ,pulmonary embolism or aortic dissection aneurysm .All cases were detected by 128‐slice spiral CT an‐giography .The original data was remodeled by the technique of multiple planar reconstruction ,maximum intensity projection ,volume representation and curved planar reformation .The lesions in coronary ,thoracic aorta and pulmona‐ry artery were observed through different angles .Of which 26 patients underwent selective coronary angiography , compared to the CTA .Results All of patients with triple check had clear display of the pulmonary arteries and tho‐racic aorta .4 cases of arrhythmia ,some segments of coronary are not clear ,ecg after editing software correction ,the i‐magines can meet the needs of the diagnosis .3 cases of breathless with poor ,part of the segmental coronary artery showed poor ,selective coronary angiography separately ,not seen coronary lesions ,all can clearly show the rest of the cases coronary artery trunk and branches at all levels .The scanning of found coronary artery muscle bridge ,plaque , stenosis and occlusion in 41 cases ,203 branches ,pulmonary embolism in 10 cases ,9 cases of aortic dissection ,aortic penetrating atherosclerotic ulcer in 4 cases ,aortic intramural hematoma in 1 case ,23 cases of non vascular lesions ,9 cases without significant abnormality .Compared with selective coronary angiography coincidence rate was 100% . Conclusion 128‐slice spiral CT angiography can one‐time showed thoracic aorta ,coronary artery and pulmonary ar‐tery ,it has high clinical value and is a useful and noninvasive examination in the diagnosis of chest pain triad .
出处
《检验医学与临床》
CAS
2015年第A02期7-9,共3页
Laboratory Medicine and Clinic
基金
重庆市基础与前沿研究计划项目（cstc2014jcyjA10120）
卫计委医学科研计划项目重庆市医学科研研计划资助项目（20142089）--（2012-2-187）.
