摘要
目的：探讨320排CT在冠状动脉旁路移植术（CABG）后随访中的应用价值。方法：回顾性分析143例CABG术后患者行320排CT造影检查（CTA）资料，对所有桥血管及自体冠状动脉320排CT扫描结果进行容积再现技术（VR）、多平面重建（MPR）、曲面重建（CPR）等后处理，综合评价桥血管有无狭窄、闭塞及通畅情况。并与14例同期行X线冠状动脉造影（CAG）患者的资料进行对照分析。结果：143例患者共计桥血管372支，CTA对372支桥血管通畅、病变情况可进行良好评估；14.2%（53/372）的桥血管发生病变，术后1年内动静脉桥血管的通畅率分别为94.3%、86.3%，随术后时间延长，动脉桥病变率呈进行性增加的趋势；胸痛组与非胸痛组桥血管通畅率差异有统计学意义；与14例患者CAG检查结果对比，320排CTA对桥血管病变诊断的灵敏度、特异度、阳性预测值、阴性预测值分别为92.3%、100%、100%、92.5%，对自体冠状动脉病变诊断的灵敏度、特异度、阳性预测值、阴性预测值分别为94.3%、96.5%、92.6%、97.4%。结论：320排CT对CABG术后桥血管病变的评价具有较高的准确率，是CABG术后随访无创性检查的首选方法。
Abstract
Objective: To evaluate the value of 320-slice CT in the follow-up after coronary artery bypass grafts(CABG). Method: One hundred and forty-three patients after CABG were studied by 320-slice computed tomography coronary angiography(CTA), images were retrospectively reconstructed under volume rendering technology(VR), maximum intensity projection(MIP), multi-planar reconstruction(MPR) and curved planar reformation(CPR). The image quality and stenosis of grafts, native vessel were evaluated; and compared with the CAG data in 14 cases of coronary angiography at the same period. Result: All the vessels including grafts and native vessel showed satisfactorily. The graft failure was found in 14.2%(53/372). One year after surgery, the patency rates of arterial and venous grafts were 94.3%, 86.3%, the rate of artery grafts lesions showed a progressive increase. There were statistically significant differences of graft patency rate between the chest pain group and non-chest pain group. Compared with 14 patients underwent CAG, the sensitivity, specificity, positive and negative predictive values of 320-slice CT were 92.3%, 100%, 100%, 92.5%. The diagnostic sensitivity, specificity, positive and negative predictive values of native vascular disease were 94.3%, 96.5%, 92.6%, 97.4%. Conclusion: The 320-slice CT in the evaluation of the lesions after CABG grafts has a high accuracy rate, it can be used as the first noninvasive method in follow-up after CABG.
关键词
冠状动脉旁路移植术 /
非体外循环 /
体层摄影术 /
螺旋计算机
Key words
Coronary artery bypass /
off-pump /
Tomography /
spiral computed
张雪凤;刘 崎;陆建平;蒋连勇;许 兵;弓 静.
320排CT在冠脉旁路移植术后随访中的应用价值[J]. 中国临床医学影像杂志. 2013, 24(9): 626-629
ZHANG Xue-feng;LIU Qi;LU Jian-ping;JIANG Lian-yong;XU Bing;GONG Jing.
The application value of 320-slice CT in follow-up for patients after coronary artery bypass grafts[J]. Journal of China Clinic Medical Imaging. 2013, 24(9): 626-629
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