64层螺旋CT后处理技术在冠状动脉支架植入术后复查中的应用价值分析
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摘要
目的旨在探讨64层螺旋CT后处理技术在冠状动脉支架植入术后复查中的应用价值。方法选取我院2016年6月-2017年11月行冠状动脉支架植入术后回院复查患者37例,均进行了CT冠状动脉成像检查,收集患者影像学资料,观察患者支架、支架血管及非支架血管的通畅程度,分析螺旋CT后处理技术在冠状动脉支架植入术后复查中的应用价值。结果共56个支架,51个(91.07%)支架通畅,CT平扫图像显示支架内密度均匀,增强扫描后冠状动脉血管密度与支架内密度相一致,支架近段未见狭窄情况,支架远端图像表现正常。多数前降支血管CPR图像显示近段见金属支架影,管腔通畅,4例患者合并钙化斑块影;3个支架出现狭窄或闭塞,CT平扫可见支架内见低密度影,CPR图像与血管横断面图像显示,管腔狭窄率约30%-70%,增强扫描中1个支架内未见造影剂影,于毗邻出见纤细侧枝循环血管影。CPR图像在27支血管中,显示支架前软斑块10个,局部管腔无明显狭窄,中段见钙化斑块;硬斑块5个,混合性斑块3个,远端软斑块5个,硬斑块2个,混合性斑块2个。心脏VR图像及心脏VR tree图像均可明显显示患者冠脉血管见金属支架影,发现37例患者中,21支血管出现非支架血管狭窄,其中单支血管13例,双支血管8例。结论 64层螺旋CT后处理技术可直观、立体显示冠状动脉内支架是否再次发生狭窄情况,能作为冠状动脉支架植入术后复查的主要检查手段。
Objective To explore the value of 64-slice spiral CT post-processing technique in the reexamination after coronary stent implantation. Methods A total of 37 cases of patients who accepted reexamination after coronary artery stent implantation in our hospital from June 2016 to November 2017 were selected. All of the patients were checked by CT coronary artery scan, and their imaging data were collected. After the observation of their patency in stents, stents blood vessels, and non-vascular stent spiral, the analysis of application value of CT post-processing technique in the reexmination of coronary artery stent implantation were represented. Results According to the CT scan image among 56 stents, 51(91.07%) stent gained patency, and uniform densit. After enhancement of scanning, coronary artery vascular density is consistent with the density of the stent, and stent stenosis was not seen at the near end, and the end of stent appeared normal. Most CPR images of the anterior descending vascular showed metal stent shadow in the near segment and patency in blood vessels, with unobstructed lumen and calcified plaque shadow in 4 patients. Three stents appeared stenosis or occlusion. CT scan was visible inside to see low density shadow, and the CPR images and vascular cross-sectional images showed that luminal stenosis rate is about 30%-30%. No contrast agent in the enhancement scanning was seen in a stent, adjacent to which slender vessels collateral circulation was observed. CPR images in 27 vessels showed 10 soft plaques in front of the stent, no obvious stenosis in the local lumen, and calcified plaques in the middle segment. There were 5 hard plaques, 3 mixed plaques, 5 soft plaques, 2 hard plaques and 2 mixed plaques. Heart VR images and heart VR tree images can clearly show that patients with coronary blood vessels had metalic stents. In 37 found cases, 21 of the blood vessels were appeared in the vascular stenosis stent, including 13 cases of single blood vessels, 8 cases of double vessels. Conclusion 64-spiral CT post-processing technique can be intuitively, three-dimensional display of coronary artery stent to show whether the stenosis happened again, it can also be used as a main approach for reexmination after coronary artery stent implantation.
Objective To explore the value of 64-slice spiral CT post-processing technique in the reexamination after coronary stent implantation. Methods A total of 37 cases of patients who accepted reexamination after coronary artery stent implantation in our hospital from June 2016 to November 2017 were selected. All of the patients were checked by CT coronary artery scan, and their imaging data were collected. After the observation of their patency in stents, stents blood vessels, and non-vascular stent spiral, the analysis of application value of CT post-processing technique in the reexmination of coronary artery stent implantation were represented. Results According to the CT scan image among 56 stents, 51(91.07%) stent gained patency, and uniform densit. After enhancement of scanning, coronary artery vascular density is consistent with the density of the stent, and stent stenosis was not seen at the near end, and the end of stent appeared normal. Most CPR images of the anterior descending vascular showed metal stent shadow in the near segment and patency in blood vessels, with unobstructed lumen and calcified plaque shadow in 4 patients. Three stents appeared stenosis or occlusion. CT scan was visible inside to see low density shadow, and the CPR images and vascular cross-sectional images showed that luminal stenosis rate is about 30%-30%. No contrast agent in the enhancement scanning was seen in a stent, adjacent to which slender vessels collateral circulation was observed. CPR images in 27 vessels showed 10 soft plaques in front of the stent, no obvious stenosis in the local lumen, and calcified plaques in the middle segment. There were 5 hard plaques, 3 mixed plaques, 5 soft plaques, 2 hard plaques and 2 mixed plaques. Heart VR images and heart VR tree images can clearly show that patients with coronary blood vessels had metalic stents. In 37 found cases, 21 of the blood vessels were appeared in the vascular stenosis stent, including 13 cases of single blood vessels, 8 cases of double vessels. Conclusion 64-spiral CT post-processing technique can be intuitively, three-dimensional display of coronary artery stent to show whether the stenosis happened again, it can also be used as a main approach for reexmination after coronary artery stent implantation.
引文
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[9]李连进,佟建洲,崔敬,等.VEGF、EGFR、PDGF在人脑胶质瘤中的表达及其与恶性程度和预后的关系[J].海南医学,2016,27(14):2251-2254.
[10]Khamis R Y,Ammari T,Mikhail G W.Gender differences in coronary heart disease[J].Heart,2016,102(14):1142-1149.
[161]郭一洁,陈宇翔,司全金.冠心病合并2型糖尿病患者冠状动脉支架置入术后支架内再狭窄的影响因素研究[J].实用心脑肺血管病杂志,2016,24(3):15-18.
[12]S.Matsumoto,Y.Yamada,M.Hashimoto,等.经导管主动脉瓣植入术(TAVI)前使用可变螺距扫描的C T成像及其对冠状动脉疾病的诊断效能[J].国际医学放射学杂志,2017,38(4):127-128.
[13]张欣畅.临床护理路径应用于急性心肌梗死患者围手术期护理中的效果观察[J].保健医学研究与实践,2017,14(2):88-90.
[2]董晓雷.64排螺旋CT横截面图像分析技术在冠脉粥样斑块诊断中的价值[J].山东医药,2017,60(37):90-92.
[3]温中炎,陈锦灿,刘永辉,等.64层螺旋CT后处理技术评价下肢血管损伤[J].影像诊断与介入放射学,2016,25(5):405-409.
[4]马虹,廖晓星.慢性稳定型心绞痛诊疗指南(1999年)--美国心脏病学院(ACC)/美国心脏学会(AHA)/美国医师学院及美国内科学会ACP-ASIM联合议定[J].岭南心血管病杂志,2000,6(3):215-216.
[5]张婕,贺莉,赵小艳,等.儿童早期脑损伤血清神经元特异性烯醇化酶与发育行为异常的相关性研究[J].医学分子生物学杂志,2017,14(3):191-192.
[6]朱广辉,余松涛,郭飞,等.64层与128层螺旋冠脉CTA在冠状动脉支架内腔再狭窄评估中的价值对比[J].中国CT和MRI杂志,2017,15(12):37-40.
[7]朱广辉,余松涛,郭飞,等.64层与128层螺旋冠脉CTA在冠状动脉支架内腔再狭窄评估中的价值对比[J].中国CT和MRI杂志,2017,14(12):37-40.
[8]卢定友,顾建华,孙维高,等.128层螺旋CT评估冠状动脉狭窄的准确性-与传统冠状动脉造影的对照研究[J].罕少疾病杂志,2016,23(6):23-25.
[9]李连进,佟建洲,崔敬,等.VEGF、EGFR、PDGF在人脑胶质瘤中的表达及其与恶性程度和预后的关系[J].海南医学,2016,27(14):2251-2254.
[10]Khamis R Y,Ammari T,Mikhail G W.Gender differences in coronary heart disease[J].Heart,2016,102(14):1142-1149.
[161]郭一洁,陈宇翔,司全金.冠心病合并2型糖尿病患者冠状动脉支架置入术后支架内再狭窄的影响因素研究[J].实用心脑肺血管病杂志,2016,24(3):15-18.
[12]S.Matsumoto,Y.Yamada,M.Hashimoto,等.经导管主动脉瓣植入术(TAVI)前使用可变螺距扫描的C T成像及其对冠状动脉疾病的诊断效能[J].国际医学放射学杂志,2017,38(4):127-128.
[13]张欣畅.临床护理路径应用于急性心肌梗死患者围手术期护理中的效果观察[J].保健医学研究与实践,2017,14(2):88-90.
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