| Part I:Coronary artery imaging technique of128-MSCT and its influencing factorsObjective:To investigate the128-slice CT coronary angiography of factors and improve image quality.Methods:The744patients clinically diagnosed of coronary artery disease and in heart rate do the128-slice CT coronary angiography with retrospectively ECG-gated, and affect the image quality of the common factors (heart rate, breathing, injection of contrast agent way) for analysis.Results:744patients, show was good in the right coronary artery (RCA)91.3%, left anterior descending artery (LAD)90.7%, L-branch (LCX) accounted for88.6%.10patients’coronary artery images who after contrast injection due to severe arrhythmia or tachycardia caused showed very poor which can not meet the diagnosis.Conclusion:To the heart rate and tidy, the heart rate after contrast injection≤70beats/min in patients, attention to overcome the image quality factors, The128-slice spiral CT generally has a higher quality image, which is non-invasive screening for coronary heart disease effective method. It haa the more important clinical significance.Part II:128-slice spiral CT evaluation of coronary atherosclerotic plaque and the relationship between coronary artery stenosisObjective:The128-slice spiral CT (MSCT) of coronary atherosclerotic plaque composition and degree of stenosis caused, and with coronary angiography (CAG) were compared to evaluate128-slice spiral CT an accurate diagnosis of coronary artery stenosis sex.Methods:The Siemens SOMATOM Definition AS MSCT of227patients with coronary angiography, in which coronary angiography CAG35cases. CT detection of plaque measured by the value of comparing different nature of the degree of luminal narrowing caused by plaque; and CAG contrast, statistical analysis of128-slice spiral CT in patients with coronary artery stenosis on the sensitivity, specificity, positive predictive value and negative predictive value, and calculate the two methods measure the degree of correlation between stenosis. Results:①plaque composition analysis:227patients,62had soft plaque, CT value (45±20) HU,75intermediate plaques, CT value (110±12) HU, calcified plaque158Department, CT value (654±219) HU,3statistically significant difference between groups (P<0.05).②mild lumen narrowing caused by calcified plaques are more moderate and severe stenosis calcified plaque more African.③128-slice spiral CT with CAG stenosis diagnosed by two higher correlation (r=0.887, P<0.05).Conclusion:The128-slice spiral CT evaluation of coronary plaque composition and caused by stenosis, the measurement results are accurate, credible, there is some clinical and practical significance.Part III:The evalucation of128-multi-slice spiral CT after intracorary stentingObjective:To investigate the128-slice CT coronary stent implantation in the value of follow-up.Methods:67patients with114stents, stent implantation according to the time classification, analysis of different time brackets after the situation, to assess the effect of coronary stenting.Results:After1year6stents wall calcification, local mild stenosis,20%stenosis,2stents proximal lumen stenosis;1-2years2stents wall calcification and mild luminal narrowing, stenosis about30%, two stents proximal stenosis;2-3years, a totally occluded stent,3stents wall calcification calcification, luminal stenosis50%;3-5years with6stents lumen wall calcification narrow, about45%stenosis,4of proximal stent lumen stenosis and plaques with mixed density, stenosis between30%-60%;5years,2stents wall calcification with stenosis, stenosis degree of about25%, and2stents proximal arterial stenosis (stenosis65%).114stents,110stents were good at both ends of vascular imaging, vascular imaging proximal stent3is poor, no developing a stent occlusion, stent occlusion in which blood vessels where no overall development.Conclusion:The128-slice spiral CT coronary stenting as a follow-up observation and understanding of the progress of an important means of coronary heart disease. |
PDF Full Text Request