螺旋CT在诊断不明急性胸痛中的价值
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[摘要] 目的：探讨64层螺旋CT在诊断不明的急性胸痛中的临床应用价值。方法：92例胸痛患者进行了64层螺旋CT胸痛三联检查扫描。采用多平面重组(Multi-planar veconstruction，MPR)、最大密度投影(Maximum intensity projection，MIP)、曲面重组(Curved-planar reconstruction，CPR)及容积再现(Volume rendering，VR)等多种重建技术显示冠状动脉、肺动脉和胸、腹主动脉，评价成像质量是否能满足临床需要。结果：92例患者中，共检出冠脉病变16例，主动脉夹层27例，肺动脉栓塞20例。结论：64层螺旋CT胸痛三联检查能够在短时间内同时完成胸部心脏大血管的CTA检查，冠状动脉、肺动脉和主动脉的图像质量可以满足临床诊断需要，在急性胸痛的病因诊断中具有较高的临床应用价值，但也有其局限性。
[关键词] 冠状动脉疾病；肺栓塞；主动脉夹层；急性胸痛；64层螺旋CT
[中图分类号] R445[文献标识码]C[文章编号]1673-7210(2011)03(c)-084-03
Value of clinical application of 64-slice spiral CT in the diagnosis of unexplained acute chest pain
YANG Jun1, HU Pengzhi2*
1.Department of Radiology, Hu'nan Children's Hospital, Changsha 410007, China; 2. Department of Radiology, Third Xiangya Hospital, Central South University, Changsha 410013, China
[Abstract] Objective: To estimate the clinical value of 64-slice spiral CT in the diagnosis of unexplained acute chest pain triad syndrome. Methods: 92 cases who presented with acute chest pain were included in the study. All of the patients underwent CTA examination to evaluate the coronary arteries, pulmonary arteries, thoracic and abdomen aorta. Multi-planar reconstruction (MPR), maximum intensity projection (MIP), curved-planar reconstruction (CPR) and volume rendering (VR) were used to display coronary arteries，pulmonary arteries，thoracic and abdomen aorta. The image quality was evaluated according to whether the examinations can fulfill the clinical demand for the differential diagnosis of acute chest pain. Results: In the 92 cases，there were 16 cases with coronary arteries disease, 27 cases with aortic dissection and 20 cases with pulmonary arteries embolism. Conclusion: CTA examination with 64-slice spiral CT can display the coronary arteries, pulmonary arteries, thoracic aorta in short time with good image quality. It is of great value of clinical application in the etiological diagnosis for the patients with acute chest pain, but also has its limitations.
[Key words] Coronary arteries disease; Pulmonary embolism; Aortic dissection; Acute chest pain; 64-slices spiral CT ......
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