中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
5期
469-471
,共3页
黄日太%薛松%徐根兴%殷焱%宋伟
黃日太%薛鬆%徐根興%慇焱%宋偉
황일태%설송%서근흥%은염%송위
冠状动脉搭桥%桥血管%多层螺旋CT%冠状动脉造影
冠狀動脈搭橋%橋血管%多層螺鏇CT%冠狀動脈造影
관상동맥탑교%교혈관%다층라선CT%관상동맥조영
Coronary artery bypass grafting%Bypass grafting%Multislice spiral CT%Coronary angiography
目的 探讨应用128层螺旋CT对冠状动脉旁路移植手术(CABG)术后桥血管病变的诊断价值.方法 对46例CABG术后(术后12～76个月)的患者行128层螺旋CT造影(MSCTA)检查,共检查133条桥血管,其中乳内动脉44条,大隐静脉89条.MSCTA检查后3～10d再行冠状动脉造影(CAG)检查,结果与MSCTA检查结果进行比较.结果 在133条桥血管中,MSCTA显示桥血管闭塞17条,桥血管狭窄(狭窄＞50％)20条.CAG结果显示桥血管闭塞17条,与MSCTA显示结果一致；桥血管狭窄(＞50％)有21条；与MSCTA检查结果比较,MSCTA检查结果假阳性1例,假阴性2例.计算MSCTA检查的敏感性为94.7％,特异性98.9％,阳性预测值97.3％,阴性预测值97.9％.结论 128层MSCTA检查可以比较准确地判断CABG术后桥血管的病变情况,是评价CABG术后桥血管病变的一种较好的无创伤检查方法.
目的 探討應用128層螺鏇CT對冠狀動脈徬路移植手術(CABG)術後橋血管病變的診斷價值.方法 對46例CABG術後(術後12～76箇月)的患者行128層螺鏇CT造影(MSCTA)檢查,共檢查133條橋血管,其中乳內動脈44條,大隱靜脈89條.MSCTA檢查後3～10d再行冠狀動脈造影(CAG)檢查,結果與MSCTA檢查結果進行比較.結果 在133條橋血管中,MSCTA顯示橋血管閉塞17條,橋血管狹窄(狹窄＞50％)20條.CAG結果顯示橋血管閉塞17條,與MSCTA顯示結果一緻；橋血管狹窄(＞50％)有21條；與MSCTA檢查結果比較,MSCTA檢查結果假暘性1例,假陰性2例.計算MSCTA檢查的敏感性為94.7％,特異性98.9％,暘性預測值97.3％,陰性預測值97.9％.結論 128層MSCTA檢查可以比較準確地判斷CABG術後橋血管的病變情況,是評價CABG術後橋血管病變的一種較好的無創傷檢查方法.
목적 탐토응용128층라선CT대관상동맥방로이식수술(CABG)술후교혈관병변적진단개치.방법 대46례CABG술후(술후12～76개월)적환자행128층라선CT조영(MSCTA)검사,공검사133조교혈관,기중유내동맥44조,대은정맥89조.MSCTA검사후3～10d재행관상동맥조영(CAG)검사,결과여MSCTA검사결과진행비교.결과 재133조교혈관중,MSCTA현시교혈관폐새17조,교혈관협착(협착＞50％)20조.CAG결과현시교혈관폐새17조,여MSCTA현시결과일치；교혈관협착(＞50％)유21조；여MSCTA검사결과비교,MSCTA검사결과가양성1례,가음성2례.계산MSCTA검사적민감성위94.7％,특이성98.9％,양성예측치97.3％,음성예측치97.9％.결론 128층MSCTA검사가이비교준학지판단CABG술후교혈관적병변정황,시평개CABG술후교혈관병변적일충교호적무창상검사방법.
Objective To evaluate the diagnostic value of 128-slice spiral CT angiography( MSCTA)for bypass grafts in patients after coronary artery bypass grafting(CABG).Methods One hundred and thirty-three bypass grafts (44 IMA grafts,89 saphenous veins grafts) of 46 patients after CABAG operation for 12 to 76 months were examined by MSCTA.Then the coronary angiography(CAG) was performed on those patients 3 - 10 days after MSCTA examination.The MSCTA results were compared with the angiography results.Results Among the 133 bypass grafts,MACTA examination showed that 17 grafts were occluded and 20 grafts were severe restenosis( restenosis degree ＞ 50％ ).There was also 17 occluded grafts showed in CAG examination as in MSCTA results.But 21 restenosis ( restenosis degree ＞ 50％ ) bypass grafts were identified by CAG.Compared with the CAG results,there was 1 false positive and 2 false negative in the MSCTA results.The overall sensitivity and specificity of MSCTA on evaluating the bypass grafts were 94.7％ and 98.9％.The positive predictive value and the negative predictive value were 97.3％ and 97.9％,respectively.Conclusion As a noninvasive examination,128-slice spiral CT could accurately identify and evaluate the bypass grafts lesions after CABG.
