CAJ | 학술논문

目的建立并评价电子束CT(EBT)两种方法在冠状动脉搭桥术后(CABG)随访应用中的价值。方法本组共214例CABG患者进行了EBT两种方法的扫描：(1)电子束CT血管造影(EBA)，以完成冠状动脉及搭桥血管的三维重建；(2)电子束CT血流扫描，以得到冠状动脉及其搭桥血管的血流曲线。结果本组共分析了589条冠状动脉搭桥血管(10条血管因图像伪影而除外)。133条动脉材料的血管桥通畅率超过静脉桥(P＜0.001)。三维重建方法诊断的敏感性、特异性和准确性分别是97.7％、94.1％和96.7％，均高于血流扫描方法(分别是88.4％、82.4％和85.2％)。动脉与静脉血管桥内的平均血流量分别为4.9±2.2 ml·min-1·g-1和6.9±2.8 ml·min-1·g-1(P＜0.001)。结论电子束CT血管造影配合三维重建方法有利于观察冠状动脉及其搭桥血管的解剖，而血流扫描方法有利于观察并定量评估搭桥血管内的血流，两种方法的结合是理想的冠状动脉搭桥术后随访的无创影像方法。
목적건립병평개전자속CT(EBT)량충방법재관상동맥탑교술후(CABG)수방응용중적개치。방법본조공214례CABG환자진행료EBT량충방법적소묘：(1)전자속CT혈관조영(EBA)，이완성관상동맥급탑교혈관적삼유중건；(2)전자속CT혈류소묘，이득도관상동맥급기탑교혈관적혈류곡선。결과본조공분석료589조관상동맥탑교혈관(10조혈관인도상위영이제외)。133조동맥재료적혈관교통창솔초과정맥교(P＜0.001)。삼유중건방법진단적민감성、특이성화준학성분별시97.7％、94.1％화96.7％，균고우혈류소묘방법(분별시88.4％、82.4％화85.2％)。동맥여정맥혈관교내적평균혈류량분별위4.9±2.2 ml·min-1·g-1화6.9±2.8 ml·min-1·g-1(P＜0.001)。결론전자속CT혈관조영배합삼유중건방법유리우관찰관상동맥급기탑교혈관적해부，이혈류소묘방법유리우관찰병정량평고탑교혈관내적혈류，량충방법적결합시이상적관상동맥탑교술후수방적무창영상방법。
Objective To establish and evaluate two protocols for the noninvasive visualization and assessment of coronary artery bypass graft (CABG) patency on electron beam tomography (EBT).Methods Two hundred and fourteen consecutive patients who underwent coronary artery bypass graft surgery were scanned using both EBT angiography with 3-dimensional reconstruction and EBT flow study with time-density-curve analysis.Results There were 589 CABGs evaluated in this study (10 grafts were excluded because of artifacts). Among them, 133 (98.5％) of 135 arterial grafts were patent, and 345 (77.7％) of 444 saphenous-vein grafts were patent. Within 5 years or between 5 and 10 years after operation, arterial graft patency exceeded venous graft patency (P ＜ 0.001 ). Three-dimensional EBT angiography achieved higher sensitivity, specificity and accuracy (97.7％, 94.1％ and 96.7％, respectively) than did EBT flow study (88.4％, 82.4％ and 85.2％, respectively) for evaluating occlusion or patency of CABG. The intra-graft flow of patent arterial and venous grafts were 4.9 ± 2.2 mi · min-1 · g-1 and 6.9 ± 2.8 mi · min-1 · g-1,respectively (P＜0.001).Conclusion The combination of EBT three-dimensional reconstruction and flow study can be more effective in the assessment of CABG anatomy and quantification of patent CABG blood flow.