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目的 分析电子束CT(EBT)三维血管重建技术对冠状动脉及其狭窄的最佳显示方法。方法 对 40例分别行EBT冠状动脉增强扫描及常规冠状动脉造影 (CAG)的病例图像行回顾性三维重建。重建方法主要是最大密度投影法 (MIP)、曲面重建法(CPR)、多平面重组法 (MPR)及容积再现法 (VR)。所有三维重建图像由 2名不知CAG结果的医师按左主干、前降支、回旋支及右冠4支血管进行分析 (分支血管未包括在内 ) ,狭窄程度以 >5 0 %为标准与CAG结果对照。结果 MIP及CPR成像清晰 ,对 48支正常冠状动脉的评价准确率达 91.7%和 93 .8% ,对 5 9支狭窄 >5 0 %血管的评价准确率分别为 83 .1%和 88.1%。VR法重建立体效果好 ,但图像易造成正常血管狭窄的假象 ,48支正常血管中有 2 9支显示狭窄改变。对有狭窄血管的程度也较CAG夸大了约 10 %～3 0 %。MPR重建图像粗糙 ,无法评价冠状动脉。结论 MIP与CPR是显示冠状动脉及其狭窄的最佳三维重建方法 ,诊断准确性高 ,VR可作为补充显示方法 ,MPR可不采用
Objective To analyze the optimal display method of coronary artery and its stenosis by electron beam computed tomography (EBT) three-dimensional reconstruction. Methods We retrospectively reconstructed 40 patients with EBV coronary angiography and routine coronary angiography (CAG). The reconstruction methods are mainly MIP, CPR, MPR and VR. All three-dimensional reconstruction images were analyzed by two physicians with unknown CAG results according to the left main branch, anterior descending branch, circumflex branch and the right coronary artery (the branch vessels were not included). The degree of stenosis was> 50% with CAG Results of the control. Results The accuracy of MIP and CPR imaging was 91.7% and 93.8% for 48 normal coronary arteries and 83.1% and 88.1% for 99 stenosis> 50% vessels respectively. VR method to reconstruct the stereoscopic effect is good, but the image easily lead to the illusion of normal vascular stenosis, 29 of 48 normal blood vessels showed stenosis. The extent of stenosis of blood vessels also exaggerated by about 10% ~ 30% over CAG. MPR reconstruction image is rough, can not evaluate the coronary artery. Conclusions MIP and CPR are the best three-dimensional reconstruction methods to show the coronary artery and its stenosis. The diagnostic accuracy is high. VR can be used as a supplementary display method. MPR may not be used