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目的总结不宜或不能行多层螺旋CT(MSCT)冠状动脉检查的心率过快、心律不齐、起搏器置入患者应用新一代电子束CT(EBCT)行无创冠状动脉成像的初步经验。方法患者36例,其中心率过快(≥90次/min)20例、心律不齐11例、起搏器置入术后16层MSCT不能触发扫描4例、扫描中心率骤升16层MSCT检查失败1例。以EBCT行冠状动脉成像检查静脉法增强扫描、前置心电门控数据采集、容积再现(VR)、最大密度投影(MIP)、曲面重组(CPR)、电影方式(cine)重组,以MIP图像评价冠状动脉管腔,以VR图像5级记分评价图像质量。结果全部患者均成功获得冠状动脉影像。冠状动脉各主支总显示率80.0%,其中左主干、前降支、右冠状动脉显示率100%,回旋支94.3%。结论新一代EBCT能够完成心率过快、心律不齐和起搏器置入术后患者的无创冠状动脉检查,并可取得满意的结果。
Objective To summarize the preliminary experience of noninvasive coronary angiography using a new generation of electron beam computed tomography (EBCT) in patients with inappropriate or impossible multi-slice spiral CT (MSCT) coronary artery examination. Methods Totally 36 patients were diagnosed as having high heart rate (≥90 beats / min), 11 cases of cardiac arrhythmia, 4 cases of 16-slice MSCT incapacitation after implantation of pacemaker and 16-slice MSCT Failure in 1 case. EBCT line coronary angiography enhanced venography scanning, pre-ECG gated data acquisition, volume rendering (VR), maximum density projection (MIP), surface reconstruction (CPR), cine (cine) recombination, MIP images Coronary lumen was evaluated and image quality was evaluated using a 5-point VR image score. Results All patients successfully obtained coronary artery images. The main coronary artery showed the total rate of 80.0%, of which the left main, anterior descending branch, the right coronary artery showed 100%, 94.3% of the circumflex artery. Conclusion The new generation of EBCT can perform noninvasive coronary examinations in patients with fast heartbeat, irregular heartbeat and pacemaker implantation and achieve satisfactory results.