多层螺旋CT冠状动脉检查.ppt

影响CT冠状动脉成像质量的主要因素
16排CT在空间分辨力方面仍是限制准确评价冠脉病变的因素

IriartX,Eur.Radiol,2007,(10)17:2581-2588
KnollmannF,Int.J.CardiovascImaging,2007Set.12
HamonM,Radiology,2007Dec,245(3):720-731.64-sliceCTwithz-Sharptechnology心脏、冠状动脉CT检查：更高的时间分辨力更高的空间分辨力最小的辐射剂量更宽的探测器（Z－轴时间分辨力）简便易行的后处理软件空间分辨力为毫米级0.4x0.4x0.4mm螺旋CT三维重建技术多层螺旋CT技术进展冠脉检查注意要点五、心脏CT成像适应症简介1－9分法CT心脏检查分级（7－9分）正常冠状动脉正常冠状动脉不同心率冠脉成像结果(支数%)正常冠状动脉左冠状动脉狭窄CTA与DSA对照CTA与DSA对照前降支狭窄明确诊断后介入治疗CT检测冠脉狭窄准确性MDCTvs.ANGIOGRAPHY冠脉粥样硬化斑块管壁偏心性斑块管壁偏心性斑块管壁偏心性斑块管壁偏心性斑块管壁环周性斑块粥样硬化斑块导致管腔狭窄冠脉血管造影冠脉支架治疗TheprogressofcoronaryatherosclerosisPlaqueruptureresultingmyocardiuminfarctionThevulnerableplaque
withoutlumenstenosisCT发现冠脉斑块的敏感度PLAQUEDETECTION：MDCTVS.IVUSThecontroversyinidentificationofplaquetypeswithMSCTSoftplaque1426HUThecontroversyinidentificationofplaquetypeswithMSCTLAD:soft-plaqueNosignificantstenosisPLAQUETRANSFORM治疗及生活习惯干预2006-08-01Cor.Dissection血管迂曲、壁冠状动脉（肌桥）血管迂曲、壁冠状动脉（肌桥）心肌桥-壁冠状动脉心肌桥相关问题Normalpatternoftheleftanteriordescendingartery(LAD)asseenonaxialplane(A,B)andmultiplanarreformation(C,D).Theleftanteriordescendingartery(arrow)isembeddedthroughallofitslengthintheepicardialfat.*Interventricularseptum.CCTAcoronarycomputedtomographicangiography.CoronarymorphologyThenormalLADIntramusculaLAD,superficialtype,asseenonaxialplane(A,B)andmultiplanarreformation(C,D).ThemidLAD(arrow)showsatypicaldeviationandstraiteningandisonlypartiallysurroundedbymyocardium.Ofnote,anatheroscleroticplaqueintheproximalLAD,whereastheintramuscularsegmentisfreeofdisease.IntramuscularLAD,rightventriculartype(arrow).InthisvariantitisfrequentlydifficulttofollowtheLADonsequentialaxialimages(A,B)becauseitdisappearsbetweentherightventriculartrabeculae,whereasthemultiplanarreformation
imageseasilyshowitsintraventricularcourse(C,D).
IntramuscularLAD,rightventriculartype(arrow).Inthisvariantitisfrequently
difficulttofollowtheLADonsequentialaxialimages(A,B)becauseitdisappears
betweentherightventriculartrabeculae,whereasthemultiplanarreformation
imageseasilyshowitsintraventricularcourse(