[多层螺旋计算机断层扫描与血管造影术对比评估冠状动脉搭桥移植血管和支架的通畅性]
[Evaluation of patency of coronary artery bypass grafts and stents using multislice spiral computed tomography in comparison with angiography].
作者信息
Pasowicz Mieczysław, Klimeczek Piotr, Przewłocki Tadeusz, Zmudka Krzysztof, Konieczyńska Małgorzata, Krochin Marek, Kozanecki Artur, Wilkołek Piotr, Sadowski Jerzy, Podolec Piotr, Tracz Wiesława
机构信息
Krakowski Szpital Specjalistyczny, Instytut Kardiologii Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
出版信息
Przegl Lek. 2002;59(8):616-9.
UNLABELLED
The aim of the study was to assess usefulness of multislice spiral computed tomography--MSCT (Somatom Plus 4 Volume Zoom, Siemens) in non-invasive assessment of the potency of coronary artery bypass grafts both venous and arterial grafts as well as stents.
METHODS
The study was performed using the MSCT method with Heart View Software with retrospective electrocardiographic gating. Nonionic, hypo-osmolar contract media was infused into a peripheral vein to highlight the coronary arteries and bypasses. All patients, due to clinical indications, underwent coronary and bypass angiography.
MATERIAL
Two group of patients (82 persons) in total were evaluated: after aorto-coronary bypassing (Group I--57 persons, incl. 40 males and 17 females) and after stent implantation (Group II--25 persons, incl. 19 males and 6 females). The patients were referred to invasive diagnostics for recurrence and aggravation of clinical symptoms.
RESULTS
In group I, the patency of 187 bypasses was evaluated (21 arterial and 166 venous). In MSCT, was found in 131 of the bypasses patency (114 venous and 4 arterial). 56 bypasses, (52 venous and 4 arterial) were obstructed. In the bypassography performed were obstructed 53 (5 venous and 3 arterial), 134 bypasses were patent (116 venous and 18 arterial). In the bypass patency assessment using MSCT compared to coronarography, specificity of 94.7% and sensitivity of 92.4% were achieved. In group II, patency was evaluated in 26 stents: 21 implanted to native vessels and 5 in venous bypasses. 19 stents in native vessels were found patent, whereas 2 were obstructed. In the coronary bypasses performed, patency was confirmed in 19 stents and 2 were obstructed. In MST obstruction was demonstrated in 4 stents in coronary bypasses, which was confirmed in bypassography. One stent was assessed patient in both methods.
CONCLUSION
The MSCT method is useful for assessment of patency of venous and arterial bypasses as well as stents.
未标注
本研究的目的是评估多层螺旋计算机断层扫描（MSCT，西门子Somatom Plus 4 Volume Zoom）在无创评估冠状动脉搭桥移植血管（包括静脉和动脉移植物）以及支架效能方面的作用。
方法
本研究采用带有心脏视图软件的MSCT方法，并进行回顾性心电图门控。将非离子型、低渗性造影剂注入外周静脉以突出冠状动脉和搭桥血管。所有患者因临床指征均接受了冠状动脉和搭桥血管造影。
材料
共评估了两组患者（82人）：主动脉冠状动脉搭桥术后（第一组——57人，包括40名男性和17名女性）和支架植入术后（第二组——25人，包括19名男性和6名女性）。这些患者因临床症状复发和加重而接受侵入性诊断。
结果
在第一组中，评估了187条搭桥血管的通畅情况（21条动脉血管和166条静脉血管）。在MSCT检查中，发现131条搭桥血管通畅（114条静脉血管和4条动脉血管）。56条搭桥血管（52条静脉血管和4条动脉血管）阻塞。在进行的搭桥血管造影中，53条（5条静脉血管和3条动脉血管）阻塞，134条搭桥血管通畅（116条静脉血管和18条动脉血管）。在使用MSCT评估搭桥血管通畅情况与冠状动脉造影相比时，特异性达到94.7%，敏感性达到92.4%。在第二组中，评估了26个支架的通畅情况：21个植入原生血管，5个植入静脉搭桥血管。发现19个植入原生血管的支架通畅，2个阻塞。在进行的冠状动脉搭桥术中，证实19个支架通畅，2个阻塞。在MSCT检查中，冠状动脉搭桥术中4个支架显示阻塞，这在搭桥血管造影中得到证实。两种方法对一名患者的一个支架进行了评估。
结论
MSCT方法可用于评估静脉和动脉搭桥血管以及支架的通畅情况。
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