| 王锡明,武乐斌,程召平,乌大尉,孙丛,晁宝婷,李振家,柳澄.双源CT在急性胸痛诊断中的临床应用[J].中国医学影像技术,2007,23(12):1797~1800 |
| 双源CT在急性胸痛诊断中的临床应用 |
| The application of dual-source CT in the diagnosis of acute chest pains |
| 投稿时间：2007-08-06 修订日期：2007-09-15 |
| DOI： |
| 中文关键词: 双源CT 动脉瘤 胸痛 冠状血管 主动脉夹层 |
| 英文关键词:Dual-source CT Aneurism Chest pain Coronary vessels Aortic dissection |
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| 中文摘要: |
| 目的 探讨双源CT在急性胸痛诊断中的临床价值。 方法 对27例临床急性胸痛的患者行双源CT心胸联合血管造影检查。采用急性胸痛的扫描参数,应用高浓度的对比剂,注射流率为5 ml/s,注射对比剂总量80~90 ml,扫描时间15~17 s,将原始数据利用Circulation 软件对冠状动脉、肺动脉和主动脉进行曲面重建(CMPR)、最大密度投影(MIP)、容积再现技术(VRT)等图像重组。由2名有经验的放射科医生利用轴位图像及各种后处理图像对疾病进行诊断。5例主动脉夹层和2例冠状动脉狭窄的患者同时行心脏彩色多普勒检查,7例主动脉夹层和4例急性心肌梗死的患者同时行选择性血管造影检查,并与双源CT诊断结果进行对照分析。 结果 双源CT心胸联合造影检查诊断为冠状动脉斑块形成并管腔狭窄9例,其中4例并发急性心肌梗死,急性肺动脉栓塞的7例,主动脉夹层的10例(其中伴有冠状动脉多发斑块并管腔狭窄的1例,主动脉夹层术后复发的2例,主动脉夹层并壁间血肿形成的1例),降主动脉瘤并冠状动脉狭窄1例。同时行选择性血管造影的患者两者的诊断结果一致,但1例主动脉夹层伴冠状动脉狭窄的患者,双源CT一次造影能同时对两种疾病作出正确的诊断,但选择性血管造影分多次造影才作出正确的诊断。7例行心脏彩色多普勒检查的患者,5例主动脉夹层的患者CDFI诊断正确,但3例没发现破口,2例冠状动脉疾病的患者CDFI未见明显异常。 结论 双源CT心胸联合血管造影检查不但能对肺动脉、主动脉等大血管疾病作出正确诊断,而且能同时发现冠状动脉疾病,因此双源CT是急性胸痛的一种无创、可靠的检查方法。 |
| 英文摘要: |
| Objective To explore the clinical value of dual-source CT in diagnosis of acute chest pains. Methods Twenty-seven patients who have acute chest pains were performed dual-source CT cardiac and chest angiography with high concentration media, injection rate 5 ml/s and gross 80—90 ml. Curved multiplannar reformation (CMPR), maximum intensity projection (MIP), volume reconstruction technique (VRT) and clipped VRT reconstruction images were performed using Circulation soft. Then two radiologists diagnosed using all images. Five cases with aortic dissection and 2 cases with coronary artery stenosis were performed color Doppler flow imaging (CDFI). Seven cases with aortic dissection and 4 cases with acute myocardial infarction were performed selected coronary anography (SCA) at the same time. Results Nine cases were diagnosed coronary artery stenosis and 4 cases were complicated with acute myocardial infarction. Seven cases were diagnosed acute pulmonary artery embolism. Aortic dissection were showed in 10 cases and 1 case have coronary embolism too. Two cases operated aortic dissection were recrudescent, 1 patient was detected aortic dissection with haematoma among aortic wall,1 case was diagnosed aortic aneurism with coronary artery stenosis. The accuracy of dual-source CT is equal to SCA, but SCA needed multi-angiography. CDFI only diagnosed aortic dissection. Three cases didn’t find dissection crevasse and 2 cases dignosed coronary artery normal. Conclusion Dual-source CT cardiac and chest angiography is a useful and noninvasive examination to diagnose acute chest pain. In a way it superior to SCA and CDFI. |
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