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目的初步探讨64排螺旋 CT 在健康人群中进行冠心病筛查的意义和方法。方法对286例40岁以上有至少一项冠心病危险因素的健康人进行64排螺旋 CT 心脏冠状动脉检查。使用东芝 Aquilion 64排螺旋 CT 机扫描,应用 TCOT 算法得到容积数据,对数据进行最大密度投影(MIP)、容积重建(VR)、多平面重建(MPR)、曲面重建(CURVE)和三维(3D)后处理,观察其对冠状动脉病变的显示,部分阳性患者与导管对照。结果 286例中发现239支血管不同程度狭窄,其中狭窄程度小于50%的138支血管,50%～75%的82支血管,大于75%的19支血管。进行导管检查的28例,并有12例做了支架手术。结论 64排螺旋 CT 心脏冠状动脉检查,是一种早期发现冠心病的快速、有效、安全、可靠、微创的检查和诊断方法。尤其对那些貌似健康无症状的冠心病患者,64排螺旋 CT 可以替代冠状动脉造影,将成为筛查冠心病的首选方法。
Objective To explore the significance and methods of 64-slice spiral CT in coronary heart disease screening among healthy population. Methods A total of 286 spiral CT cardiac coronary artery examinations were performed on 286 healthy subjects over the age of 40 who had at least one risk factor for coronary heart disease. Using the Toshiba Aquilion 64-slice spiral CT scanner, volume data were obtained by using the TCOT algorithm. The data were subjected to maximum density projection (MIP), volume reconstruction (VR), multiplanar reconstruction (MPR), surface reconstruction and 3D. Post-treatment, to observe its coronary lesions, some positive patients and catheter control. Results Of the 286 cases, 239 vessels with different degrees of stenosis were found. Among them, 138 vessels with stenosis of less than 50%, 82 vessels of 50% -75% and 19 vessels of more than 75% were found. 28 cases underwent catheterization and 12 cases underwent stent-graft surgery. Conclusion 64-slice spiral CT heart coronary artery examination is an early detection of coronary heart disease is a fast, effective, safe, reliable and minimally invasive examination and diagnosis. Especially for those who look like healthy asymptomatic patients with coronary heart disease, 64-slice spiral CT can replace coronary angiography, coronary heart disease will become the screening method of choice.