| 郭满涛,范晓娥,刘哲,等.重建技术及上胸部补充扫描对冠状动脉 CT血管造影发现心外病灶的价值[J].安徽医药,2022,26(4):680-684. |
| 重建技术及上胸部补充扫描对冠状动脉 CT血管造影发现心外病灶的价值 |
| Clinical value of reconstruction technique and supplementary upper chest scan in detecting extra-cardiac lesions by coronary computed tomography angiography |
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| DOI：10.3969/j.issn.1009-6469.2022.04.009 |
| 中文关键词: 胸痛 计算机体层摄影血管造影术 心外病变 冠状动脉 补充扫描 |
| 英文关键词: Chest pain Computed tomography angiography Extra-cardiac finding Coronary artery Supplementary scan |
| 基金项目:陕西省重点研发计划项目( 2017SF-023) |
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| 中文摘要: |
| 目的观察冠状动脉 CT血管造影(CCTA)检查后，大视野重建技术及上胸部补充扫描对心外病变检测中的临床价值。方法选取 2014年 2月至 2018年 3月陕西省人民医院收治的 230例因可疑冠状动脉粥样硬化性心脏病(冠心病)行 CCTA的病人，并且病人在行 CCTA同时行补充上胸部 CT检查。对 CCTA图像进行大视野重建，而后将心外病灶分类，观察发现心外病灶分类情况；比较年龄 <60岁组及年龄 ≥60岁组在大视野重建及补充上胸部 CT扫描后心外病灶检出情况。结果 201例(201/230，87.39%)病人检出心外病灶 293处，其中 Ⅰ类病灶 16处， Ⅱ类病灶 51处， Ⅲ类病灶 68处， Ⅳ类病灶 158处；在发现的心外病灶数目中年龄 ≥60岁组占 69.28%(203/293)高于 <60岁组的 30.72%(90/293)；因发现 Ⅰ类及 Ⅱ类病灶而改变诊疗方案者共计 62例，其中年龄 <60岁组中 |
| 英文摘要: |
| Objective To explore the clinical application value of large FOV reconstruction technique and supplementary upperchest scan in the detection of extra-cardiac lesions after coronary computed tomography angiography (CCTA).Methods A total of 230 suspected CAD patients who received CCTA and a supplementary scan of the upper chest in Shaanxi Provincial People's Hospital fromFebruary 2014 to March 2018 were enrolled in this study. The CCTA images were performed by the large FOV (including the entire tho rax) reconstruction technique, and then the extracardiac lesions were classified, and the classification of extracardiac lesions was ob served. The difference of extracardiac lesions detected in < 60 year old group and ≥ 60 year old group after large FOV reconstructiontechnique and supplementary upper chest scan according to age groups.Results 230 cases of extra-cardiac lesions were found in 201 patients (201/230, 87.39%%), among them, 16 were type I lesions, 51 were type Ⅱ lesions, 68 were type Ⅲ lesions and 158 were typeIV lesions. In the number of extra-cardiac lesions, 69.28% (203/293) in the age group ≥ 60 years old was higher than 30.72% (90/293)in the age group < 60 years old. There were 62 patients who changed the treatment plan due to the discovery of typeⅠand Ⅱ lesions.Among them, 20.38% of patients (21/103) in the age group < 60 changed the diagnosis and treatment plan, and 32.28% of patients (41/127) in the age group ≥ 60 changed the diagnosis and treatment plan. The difference was statistically significant (P<0.05).Conclusion Large FOV reconstruction technique and supplementary upper chest scan can basically cover the whole chest scanning range and de tect more incidental extra-cardiac lesions in CCTA examination, especially in older patients, it can also avoid the radiation dose re ceived by patients undergoing chest CT examination again and partially change the diagnosis and treatment plan for patients with chestpain, which is worthy of further promotion and application. |
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