16 層螺旋CT 冠狀動脈成像初步探討
朱海峰 范家棟 鄭卓肇 何匯忱 舒邦明
【摘要】 目的 探討心率與多層螺旋CT( MSCT) 冠狀動脈( 簡稱冠脈) 成像運動偽影的關系, 及
MSCT 冠脈成像的臨床應用價值。方法 對200 例臨床擬診冠心病的患者行MSCT 冠脈成像檢查, 分
析掃描時心率與冠脈運動偽影的關系; 其中37 例同時行常規冠脈造影( 簡稱冠造) 檢查, 對比分析
2 種檢查結果。結果 掃描時心率≤ 55 次/min、56 ～60 次/min、61 ～65 次/min、66 ～70 次/min
和> 70 次/min組有運動偽影的冠脈節段分別占冠脈總數的0. 1% ( 1 /759) 、1. 1% ( 7 /649) 、2. 5%
( 10 /407) 、42. 6% ( 103 /242) 和75. 5% ( 108 /143) ; 以常規冠造作為金標準, MSCT 診斷狹窄≥50% 的
敏感度、特異度、陽性預測值、陰性預測值分別為79. 2% 、96. 0% 、83. 8% 、94. 6% 。掃描時心率與冠脈
運動偽影的數量顯著相關( r = 0. 655, P = 0. 000) 。結論 MSCT 能較準確診斷冠脈50% 以上的狹窄,
是無創性診斷冠脈狹窄的重要工具。
【關鍵詞】 冠狀動脈疾病; 體層攝影術, X 線計算機; 心血管造影術
Initial experiences about 16-detector row CT corona ry a ngiogra phy ZHU Hai-feng* , FAN J ia-dong,
ZHENG Zhuo-zhao, HE Hui-chen, SHU Bang-ming. * Department of Radiology, CAAC General Hospital,
Beijing 100025, China
【Abstra ct 】 Object ive To investigate the influence of a patient′s heart rate on the presence of
motion artifacts and on accuracy of stenosis detection on contrast-enhanced MSCT. Methods Two hundred
patients with suspected coronary artery disease underwent the contrast-enhance MSCT, the main factors
influencing imaging quality were analyzed. Thirty-seven patients underwent conventional selective coronary
angiography in the same time. The results obtained from MSCT were compared. Results In the 5 groups
( heart rate≤55 bpm, 56—60 bpm, 61—65 bpm, 66—70 bpm, > 70 bpm during scan) , the proportion of
segments that could not be assessed because of motion artifact were 0. 1% ( 1 / 759) , 1. 1% ( 7 / 649) , 2. 5%
( 10 /407 ) , 42. 6% ( 103 /242 ) , and 75. 5% ( 108 /143 ) , respectively. With conventional selective
coronary angiography as the golden standard, the sensitivity, specificity, positive and negative prediction
values to detect ≥ 50% stenotic lesions in the assessable segments were 79. 2% , 96. 0% , 83. 8% , and
94. 6% , respectively. There was a significant correlation between the number of segments per patient not
assessable because of motion artifact and heart rate during the scan ( r = 0. 655, P = 0. 000 ) . Conclusion
MSCT is capable of achieving high accuracy for detection of coronary artery stenosis, and is a reliable
technique to diagnose coronary artery disease.
【Key wor ds】 Coronary disease; Tomography, X-ray computed; Angiocardiography

16 層螺旋CT 冠狀動脈成像初步探討--心血管.rar