健康体检中多层螺旋CT冠脉成像初步观察.doc

健康体检中多层螺旋CT冠脉成像初步观察【摘要】 目的 探讨健康体检中多层螺旋CT冠脉成像(CTCA)对冠脉病变的价值。方法 对随机抽取的289例健康体检时进行CTCA的病例作冠脉钙化(CAC)的定性分析,然后分别对CAC阴性者和CAC阳性者的冠脉狭窄情况进行统计分析。结果 289名受检者中77例为CAC阳性,占26.64%;212例为CAC阴性,占73.36%。在CAC阳性者中检出冠脉狭窄57例,占74.03%;CAC阴性者中检出冠脉狭窄21例,占9.91%。结论 在健康体检时行胸部CT检查发现CAC阳性者,均应做CTCA检查;对CAC阴性者,如有高血糖、高血压、高血脂、吸烟者或有胸闷史者,也应做CTCA检查,以明确有无非钙化斑块的存在,避免非钙化斑块的漏诊。 【关键词】 健康体检;多层螺旋CT;冠状动脉;钙化;血管造影 【Abstract】 Objective To explore the value of multi-slice spiral CT coronary angiography (CTCA)for the coronary artery lesions in health examination.Methods Qualitative analysis of coronary artery calcification(CAC)was performed in 289 cases healthy subjects who were randomly selected,and then coronary stenosis in subjects with negative and positive CAC was analyzed statistically.Results Of 289 subjects,positive CAC were found in 77 cases,accounting for 26.64%;negative CAC in 212 cases,accounting for 73.36%.57 cases of coronary stenosis were detected in subjects with positive CAC,accounting for 74.03%;21 cases of coronary stenosis were detected in subjects with negative CAC,accounting for 9.91%.Conclusion All subjects with positive CAC found by chest CT scan should take CTCA examination.For subjects with negative CAC,if they have hyperglycemia,hypertension,hyperlipemia,medical history of smoking or dyspnea,CTCA is also need to be performed to make confirmation of non-calcified plaque and avoid the misdiagnosis. 【Key words】 Health examination;Multi-slice spiral CT;Coronary artery;Calcification;Angiography 随着多层螺旋CT(MSCT)的普及与应用的增多,对冠状动脉(文中简称冠脉)狭窄患者冠脉钙化(CAC)情况的研究国内外时有报道,相反,对CAC阳性者及阴性者,尤其是健康体检中CAC阳性者及阴性者冠脉狭窄情况的研究报道较少;除了以诊断冠心病为目的行多层螺旋CT冠脉成像(CTCA)检查时会出现CAC阳性的情况外,在健康体检时以排除肿瘤或其他疾病为目的而做的胸部CT检查平扫时也常出现冠脉行走区钙化的征象。本文则对在我院以及上海、南通两家医院常规健康体检时行CTCA的病例之相关情况进行了初步观察与分析,以探索亚临床人群健康体检时CTCA的使用价值及必要性与可行性,以期对后面的相关研究有所启示。 1材料与方法 1.1临床资料随机收集2006-06―2009-12间在我院和上海市第一人民医院、南通市第一人民医院两家三级甲等综合性医院健康体检时行CTCA的病例289例。年龄分组:40～49岁组65人,50～59岁组89人,60～69组98人,≥70岁组37人;男性157人,女性132人。在289例受检者中,有24例近期偶有胸闷,32例血压高于正常,27例有糖尿病史,34例血脂高于正常,有吸烟