CAJ | 학술논문

目的：探讨双源 CT(DSCT)冠状动脉成像评估主动脉瓣形态及运动的可行性及准确性。方法125例临床拟诊冠状动脉病变患者行 CT 冠状动脉成像及经胸心脏超声(TTE)检查。间隔5%R-R 间期重建0%~95%R-R 间期20组数据。电影模式动态观察一次完整心动周期中各期相上主动脉瓣形态、开放及关闭情况,以及图像质量。采用方差分析比较收缩期各期相上主动脉瓣口面积(AVA)。结果125例患者共2500期图像中,92.3%图像为可评估图像；DSCT 显示123例三瓣型主动脉瓣,二瓣畸型2例；主动脉瓣退行性改变27例,主动脉瓣瓣叶关闭不全26例,与 TTE 对照,存在3例假阳性,假阴性2例；92%主动脉瓣在0%~35%期相上呈开放状态,75.2%在40%~95%期相上呈关闭状态；收缩期各期相上 AVA 存在统计学差异(F =2.97,P <0.05)。结论DSCT 可在完整心动周期中准确、动态显示主动脉瓣形态及运动情况,在收缩期中期主动脉瓣图像质量最佳,且 AVA 最大。
목적：탐토쌍원 CT(DSCT)관상동맥성상평고주동맥판형태급운동적가행성급준학성。방법125례림상의진관상동맥병변환자행 CT 관상동맥성상급경흉심장초성(TTE)검사。간격5%R-R 간기중건0%~95%R-R 간기20조수거。전영모식동태관찰일차완정심동주기중각기상상주동맥판형태、개방급관폐정황,이급도상질량。채용방차분석비교수축기각기상상주동맥판구면적(AVA)。결과125례환자공2500기도상중,92.3%도상위가평고도상；DSCT 현시123례삼판형주동맥판,이판기형2례；주동맥판퇴행성개변27례,주동맥판판협관폐불전26례,여 TTE 대조,존재3례가양성,가음성2례；92%주동맥판재0%~35%기상상정개방상태,75.2%재40%~95%기상상정관폐상태；수축기각기상상 AVA 존재통계학차이(F =2.97,P <0.05)。결론DSCT 가재완정심동주기중준학、동태현시주동맥판형태급운동정황,재수축기중기주동맥판도상질량최가,차 AVA 최대。
Objective To explore the feasibility and accuracy of dual-source computed tomography(DSCT)coronary angiography for evaluation the morphology and motion of aortic valve.Methods A total of 125 cases with suspected coronary artery disease un-derwent computed tomography coronary angiography and transthoracic echocardiography examination.Twenty CT data sets were re-constructed in 5% steps from 0% to 95% of R-R interval.The morphologic features,changes of motion and image quality of the aortic valve in cardiac cycle were observed and recorded with CT dynamic cine-mode technique.The differences of aortic opening area in the various phases of the systole were analyzed by using ANOVA.Results 92.3% of aortic valve images among the total 2500 phases were good enough for evaluated in the 125 patients examined.DSCT visualized 123 patients with tricuspid aortic valve while 2 patients with bicuspid aortic valve.27 patients with degenerative aortic valve disease were identified.CT correctly identified 26 patients with aor-tic insufficiency during diastole.Compared with TTE,3 patients were false positives and two patients were false negatives on DSCT. Aortic valve opening was seen in phase 0% to 35% in 92% of patients,and it was closed during phase 40% to 95% of R-R interval in 75.2% of patients.There were significant difference between the AVA in the various phases of the systole(F =2.97,P <0.05). Conclusion DSCT allows accurate and dynamic visualization of morphology and motion of aortic valve throughout the cardiac cycle. The area of the aortic opening is widest and image quality is best during midsystole.