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目的探讨多层螺旋CT冠状动脉造影(multislice spiral CT coronary angiography,MSCTCA)的成像技术及其临床应用价值。方法对86例行MSCTCA检查,采用多种重建方法对原始数据进行重建,分析影响冠状动脉图像质量的因素,分析MSCT对冠状动脉的显示能力、分析冠状动脉斑块性质及钙化程度,评价管腔狭窄及其程度,并对桥血管和支架的显示及通畅性进行评价。结果左冠状动脉主干及前降支重建的最佳时相为75%R-R时相,左回旋支及右冠状动脉为65%R-R时相。以75%的相位窗重建得到容积再现的图像为最佳。MSCTCA对冠状动脉1~3级分支、甚至部分4级分支显示清晰,对冠状动脉斑块显示良好,对冠状动脉狭窄显示较佳;对搭桥血管及内支架显示良好。结论MSCTCA可作为冠心病的筛选手段及对冠状动脉血运重建术后复查有很高的临床应用价值。
Objective To investigate the imaging technique of multislice spiral CT coronary angiography (MSCTCA) and its clinical value. Methods Eighty-six patients underwent MSCTCA. Reconstruction of the original data was performed using a variety of reconstruction methods. Factors influencing the quality of coronary arteries were analyzed. The ability of MSCT to display coronary arteries was analyzed. Coronary plaque characteristics and calcification were analyzed. Stenosis and its extent, and the assessment of the display and patency of the bridge vessels and stents. Results The optimal time of left main coronary artery and anterior descending artery reconstruction was 75% R-R phase, left circumflex artery and right coronary artery were 65% R-R phase. It is best to reconstruct the volume reproduced image with a 75% phase window. MSCTCA of the coronary artery 1 to 3 branches, and even some 4 branches showed a clear, good for coronary plaque, coronary stenosis showed better; on the bypass vessel and stent showed good. Conclusion MSCTCA can be used as a screening tool for coronary heart disease and has a high clinical value for postoperative coronary revascularization.