128层CT冠脉成像-周胜利,讲义[精品].ppt

管状狭窄 冠状动脉瘤 * 动脉导管未闭 女，13岁。发现心杂杂音10年。CT示动脉导管未闭，肺动脉高压。 PA PDA PDA RV LV PA AO * 对支架术后的复查 * 对冠状动脉支架的评估 主要观察和评价冠状动脉支架的通 畅程度、形态或变形程度。 * 左前降支支架植入术后 * 支架内狭窄 左前降支的支架内血管内膜局限性过度增生伴狭窄 * 支架内狭窄 左前降支的支架内血管内膜弥漫性过度增生伴狭窄 * 冠状动脉搭桥术后 * C P R显示桥血管通畅，后降支近段闭塞 * 右冠主干、前降支及回旋支搭桥术后 * 128层CT与冠脉造影的诊断价值比较 * 二者检查结果一致 * 对于斑块性质确定冠造不如CT * 心率过快CT不如冠造 * 开口变异的显示冠造不如CT * MSCT的优势 1、MSCT对于冠脉开口变异，能很好的显示血管的开口情况，而开口变异使冠脉造影难度增大，甚至失败。 2、MSCT能很好的确定冠脉斑块的性质，而冠脉造影确定斑块性质困难 3、MSCT能显示冠脉以外的病变：如肌桥、肿瘤等，而冠脉造影则显示困难 * 4、MSCT可对冠脉进行任意角度观察，充分显示病变 5、MSCT危险性小、程序简单、费用低廉、不住院病人容易接受。 6、MSCT对于支架及搭桥术后复查优势明显 * 谢谢！ * * * * * I would like to give a brief overview of the clinical applications that we are doing today with Cardiac CT. The first application is imaging and quantification of the coronary calcium. The presence of coronary calcium is a marker of coronary artery disease. This has been done in the past with Electron Beam CT and even using X-ray fluoroscopy. The next major application is Cardiac CT Angiography. This is the applications that general a lots of excitement in the medical world of radiology and cardiology for the last 2 years. * I would like to give a brief overview of the clinical applications that we are doing today with Cardiac CT. The first application is imaging and quantification of the coronary calcium. The presence of coronary calcium is a marker of coronary artery disease. This has been done in the past with Electron Beam CT and even using X-ray fluoroscopy. The next major application is Cardiac CT Angiography. This is the applications that general a lots of excitement in the medical world of radiology and cardiology for the last 2 years. CT冠状动脉成像为心电后门控成像，需要选择一个心动周期中心脏搏动幅度最小的时相重建，得到最清晰的冠状动脉图像，将一个心电周期按百分比表示，重建35%—80%的图像，通常75%的心电间隔为最佳重建时相 * * 自动重建心房、心室，自动对不同的组织、结构配备不同的色彩，可清晰显示各个房室结构和冠脉的全景视图，更有助于显示先心、大血管异位等病变的三维形态学解剖 * 显示心脏的专有特殊位置：四腔心长轴位相、短轴位相、左室长轴位相，清晰显示心脏的内部结构，房、室间隔，瓣膜形态、心肌厚度，心腔内占位等一系列诊断信息 * * * 搭桥患者的术后管理，也体现着更安全、更有效、经济的和简单的手段出发点。 * 右冠近端软斑块 * 左冠及前降支软斑块 * 冠脉混合密度斑块 * 左回旋支软硬混合斑块 * 右冠混合斑块 * 右冠多发混