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目的应用64排CT冠状动脉成像观察冠脉内支架的开通及再狭窄情况,并与CAG结果进行比较。探讨在临床上应用64排CT评价冠状动脉支架的性状及其通畅性情况。方法 36例接受冠脉支架置入术的冠心病患者(共放置支架51枚)行MSCT冠状动脉造影。MSCT采用回顾性心电门控技术,球管旋转时间为0.35S;扫描层厚为0.625mm;管电压为120kV;管电流为140mAs;螺距为0.22～0.31。采用节段重建法,将全部患者的心脏CT图像原始数据在R-R间期的45～80%心电相位窗上进行横断面CT图像重建并传送到图像工作站。观察支架开通和再狭窄情况,在冠脉支架节段利用图像处理软件测量支架的内径。结果 MSCT冠状动脉成像的检查结果显示,36例患者所植入的51个支架中,40个支架畅通,其中MSCT冠脉造影评价结果和CAG一致者39例,并可以测量支架管腔直径;3个支架显示高度狭窄或完全闭塞(≥75%),与CAG结果一致。结论 MSCT不仅显示准确、全面、细致,而且无创、重复性好,图像更加直观可信,具有很高的临床价值。
Objective To investigate the opening and restenosis of coronary stents by 64-slice CT coronary angiography and to compare with CAG results. To investigate the clinical application of 64-slice CT evaluation of coronary stent characteristics and patency. Methods Thirty-six patients with coronary heart disease undergoing coronary stent implantation (total 51 stent placement) underwent MSCT coronary angiography. MSCT retrospective ECG gating technology, the tube rotation time of 0.35S; scanning layer thickness of 0.625mm; tube voltage of 120kV; tube current of 140mAs; pitch 0.22 ~ 0.31. The segmental reconstruction method was used to reconstruct the CT data of all the patients’ cardiac CT images from 45% to 80% of the R-R ECG phase window and transmit them to the image workstation. Observation of stent opening and restenosis, coronary stent segment using image processing software to measure the stent diameter. Results The results of MSCT coronary angiography revealed that of the 51 scaffolds implanted by 36 patients, 40 scaffolds were clear. Among them, MSCT coronary angiography was consistent with CAG in 39 patients and scaffold lumen diameter could be measured.3 Stents showed a high degree of stenosis or complete occlusion (≥75%), consistent with CAG results. Conclusion MSCT not only shows accurate, comprehensive and meticulous, but also non-invasive, good reproducibility, the image is more intuitive and credible, with high clinical value.