冠状动脉搭桥术通畅性的随访：高螺距双源256层MDCT检查结果的诊断效能

Follow-up of coronary artery bypass graft patency: diagnostic efficiency of high-pitch dual-source 256-slice MDCT findings.

作者信息

Yuceler Zeyneb, Kantarci Mecit, Yuce Ihsan, Kizrak Yesim, Bayraktutan Ummugulsum, Ogul Hayri, Kiris Adem, Celik Omer, Pirimoglu Berhan, Genc Berhan, Gundogdu Fuat

机构信息

From the *Mehmet Akif Ersoy Training and Research Hospital, Department of Radiology, İstanbul; †Atatürk University, School of Medicine, Department of Radiology; and ‡Regional Training and Research Hospital, Department of Radiology, Erzurum;§Mehmet Akif Ersoy Training and Research Hospital, Department of Cardiology, İstanbul;∥Şifa University, School of Medicine, Department of Radiology, İzmir; and ¶Atatürk University, School of Medicine, Department of Cardiology, Erzurum, Turkey.

出版信息

J Comput Assist Tomogr. 2014 Jan-Feb;38(1):61-6. doi: 10.1097/RCT.0b013e3182a58a8c.

DOI:10.1097/RCT.0b013e3182a58a8c

PMID:24378890

Abstract

OBJECTIVES

Our aim was to evaluate the diagnostic accuracy of 256-slice, high-pitch mode multidetector computed tomography (MDCT) for coronary artery bypass graft (CABG) patency.

METHODS

Eighty-eight patients underwent 256-slice MDCT angiography to evaluate their graft patency after CABG surgery using a prospectively synchronized electrocardiogram in the high-pitch spiral acquisition mode. Effective radiation doses were calculated. We investigated the diagnostic accuracy of high-pitch, low-dose, prospective, electrocardiogram-triggering, dual-source MDCT for CABG patency compared with catheter coronary angiography imaging findings.

RESULTS

A total of 215 grafts and 645 vessel segments were analyzed. All graft segments had diagnostic image quality. The proximal and middle graft segments had significantly (P < 0.05) better mean image quality scores (1.18 ± 0.4) than the distal segments (1.31 ± 0.5). Using catheter coronary angiography as the reference standard, high-pitch MDCT had the following sensitivity, specificity, positive predictive value, and negative predictive value of per-segment analysis for detecting graft patency: 97.1%, 99.6%, 94.4%, and 99.8%, respectively.

CONCLUSIONS

In conclusion, MDCT can be used noninvasively with a lower radiation dose for the assessment of restenosis in CABG patients.

摘要

目的

我们的目的是评估256层、高螺距模式的多排螺旋计算机断层扫描（MDCT）对冠状动脉旁路移植术（CABG）血管通畅性的诊断准确性。

方法

88例患者在高螺距螺旋采集模式下，采用前瞻性同步心电图，接受256层MDCT血管造影，以评估CABG术后移植物的通畅情况。计算有效辐射剂量。我们将高螺距、低剂量、前瞻性、心电图触发、双源MDCT对CABG血管通畅性的诊断准确性与导管冠状动脉造影成像结果进行了比较。

结果

共分析了215个移植物和645个血管节段。所有移植物节段均具有诊断图像质量。近端和中间移植物节段的平均图像质量评分（1.18±0.4）显著（P<0.05）优于远端节段（1.31±0.5）。以导管冠状动脉造影为参考标准，高螺距MDCT在检测移植物通畅性的节段分析中，其敏感性、特异性、阳性预测值和阴性预测值分别为97.1%、99.6%、94.4%和99.8%。