利用电子束断层扫描的三维重建和血流研究评估冠状动脉搭桥术的血管通畅情况。
Evaluation of coronary artery bypass graft patency using three-dimensional reconstruction and flow study on electron beam tomography.
作者信息
Lu B, Dai R P, Jing B L, Bai H, He S, Zhuang N, Wu Q Y, Budoff M J
机构信息
Department of Radiology, Cardiovascular Institute and FuWai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing.
出版信息
J Comput Assist Tomogr. 2000 Sep-Oct;24(5):663-70. doi: 10.1097/00004728-200009000-00001.
OBJECTIVES
To establish and evaluate two protocols for the noninvasive visualization and assessment of coronary artery bypass graft (CABG) patency on electron beam tomography (EBT).
METHODS
Two hundred fourteen consecutive patients who underwent CABG surgery were scanned using both EBT angiography with three-dimensional reconstruction and EBT flow study with time-density curve analysis.
RESULTS
There was a total of 589 CABGs evaluated in this study (10 grafts were excluded because of artifacts); 133 (98.5%) of 135 arterial grafts were patent, 345 (77.7%) of 444 saphenous vein grafts were patent. Within 5 years or 5-10 years after surgery, arterial graft patency exceeded venous graft patency (p<0.001). Three-dimensional EBT angiography achieved higher sensitivity, specificity, and accuracy (97.7%, 94.1%, and 96.7%, respectively) than EBT flow study (88.4%, 82.4%, and 85.2%, respectively) for evaluating occlusion or patency of CABGs. The intragraft flow of patent arterial and venous grafts were 4.9+/-2.2 ml/min/g and 6.9+/-2.8 ml/min/g, respectively (p<0.001).
CONCLUSION
The combination of EBT three-dimensional reconstruction and flow study can be more effectively performed in the assessment of CABG anatomy and quantification of patent CABG flow.
目的
建立并评估两种用于电子束断层扫描（EBT）无创可视化和评估冠状动脉旁路移植术（CABG）通畅情况的方案。
方法
对214例连续接受CABG手术的患者进行扫描，采用三维重建的EBT血管造影和时间密度曲线分析的EBT血流研究。
结果
本研究共评估了589条CABG（10条移植物因伪影被排除）；135条动脉移植物中有133条（98.5%）通畅，444条大隐静脉移植物中有345条（77.7%）通畅。术后5年内或5 - 10年内，动脉移植物通畅率超过静脉移植物通畅率（p<0.001）。在评估CABG闭塞或通畅情况时，三维EBT血管造影的敏感性、特异性和准确性（分别为97.7%、94.1%和96.7%）高于EBT血流研究（分别为88.4%、82.4%和85.2%）。通畅的动脉和静脉移植物内血流量分别为4.9±2.2 ml/min/g和6.9±2.8 ml/min/g（p<0.001）。
结论
EBT三维重建和血流研究相结合能更有效地用于评估CABG的解剖结构和定量分析通畅的CABG血流量。
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