| 郑敏文,宦怡,孙立军,杨勇,葛雅丽,赵宏亮,石明国,张劲松,彭勇.多层螺旋CT与电子束CT冠状动脉成像的对照研究[J].中国医学影像技术,2006,22(5):722~725 |
| 多层螺旋CT与电子束CT冠状动脉成像的对照研究 |
| Comparison of image quality in coronary artery visualization by electron beam CT and multislice spiral CT |
| 投稿时间：2005-12-27 修订日期：2006-01-06 |
| DOI： |
| 中文关键词: 冠状血管造影术 冠状动脉疾病 体层摄影术,X线计算机 |
| 英文关键词:Coronary angiography Coronary disease Tomography, X-ray computed |
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| 中文摘要: |
| 目的 对比多层螺旋CT(MSCT)和电子束CT(EBCT)冠状动脉成像的优劣势。方法 23例可疑冠心病患者或查体者分别经EBCT和MSCT血管造影检查。由2名有经验的心血管专业放射诊断医师分别阅读两组资料片,将冠状动脉各支共分成4支9个节段,逐一对照两种检查方法所显示的各支冠状动脉主干的可视长度、可评价长度,各节段血管成像质量等级比率,不同三维重建方法及其对斑块的显示优势,并进行统计学分析。结果 ①MSCT和EBCT所显示的冠状动脉各主干血管的可视长度没有统计学差异,但对前降支和回旋支的可诊断长度显示有统计学差异(P＜0.05, P＜0.01)。②MSCT的A级节段比和B级节段比均高于EBCT,总的可诊断节段比明显高于EBCT(P＜0.01);而C级节段比则明显低于EBCT(P＜0.01)。MSCT的C级节段主要集中在运动伪影明显的右冠中段,EBCT的C级节段则主要集中在前降支和回旋支远段。③MSCT可显示EBCT无法显示的血管上、下壁的非钙化性斑块和EBCT易遗漏的管壁一侧的轻度增厚改变。④在各种三维重建方法中,除了轴位MIP血管显示两种检查方法没有明显差别,其他三维重建方法的成像清晰度MSCT均优于EBCT。结论 MSCT对冠状动脉前降支和回旋支的成像及非钙化性斑块的显示优于EBCT,但右冠成像因中段频繁的运动伪影而明显劣于EBCT。EBCT和MSCT,尤其是MSCT,是极有临床应用价值和发展潜力的无创性冠状动脉成像技术,虽然不能完全替代冠状动脉造影,但可作为冠心病的常规筛选检查方法,减少有创检查。 |
| 英文摘要: |
| Objective To compare the image quality of coronary artery visualization by electron beam CT (EBCT) and multislice spiral CT (MSCT). Methods Twenty-three patients with suspected coronary artery disease underwent both EBCT and MSCT. Overall length of the visualized coronary arteries and evaluable vessel length were measured, image quality of coronary arteries was evaluated, and different three-dimensional reconstruction methods were compared by two experienced cardiovascular radiologists. Results There was no significant difference that overall visualized length of the coronary arteries between MSCT and EBCT, but MSCT depicted significantly longer diagnosable segments of the left anterior descending (length: vs mm, P<0.05) and the left circumflex coronary arteries (length: vs mm, P<0.01) than EBCT. In MSCT, the segments' percentage both quality A and quality B were higher than that in EBCT, as well as the percentage of diagnosable segments (P＜0.01). On the contrary, a significantly smaller proportion of quality C segments of the coronary arteries was visualized in MSCT. Of all segments of quality C in MSCT, most were mid right coronary arteries, and in EBCT were distal segments of left anterior descending and circumflex coronary arteries. Noncalcification plaques within upper, lower or lateral vascular wall were more easily shown by MSCT. The imaging quality of reconstructed coronary arteries by conventional three-dimensional reconstruction methods in MSCT were better than that in EBCT except cross section maximum intensity projection. Conclusion Because its higher spatial resolution and lower image noise, MSCT seems to be superior to EBCT in the visualization of the coronary arteries despite motion artifacts of right coronary artery were more frequent than in EBCT. Both EBCT and MSCT enable non-invasive visualize coronary arteries and evaluate coronary artery diseases. |
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