多层螺旋CT冠状动脉检查PPT.ppt

VENTRICULAR TYPE(深在型） MB-MCA ON RCA Atherosclerosis on MCA Right ventricular type Right ventricular type Right ventricular type MCA on diastolic and systolic phase diastolic phase systolic phase MCA: Mural Coronary Artery MCA on Diastolic phase MCA on systolic phase MB-MCA MB: Myocardial Bridge, MCA: Mural Coronary Artery MCA on diastolic and systolic phase Diastolic phase Systolic phase M，42y，AMI 4 years (at 38 years old) RCA: NO SIGNIFICANT STENOSIS LCX: NO SIGNIFICANT STENOSIS MB: Myocardial Bridge MCA: Mural Coronary Artery LAD: MB-MCA F，67y，EFFORT ANGINA，3M Myocardial infarction F，67y，EFFORT ANGINA，3M M, 53 y, Chest Malaise 3 years Myocardial ischemia 女63岁，冠心病17年，高血压2年 扩张性心肌病 肥厚性心肌病 术前 术后 瓣膜病变 左房黏液瘤 心脏肿瘤—心房肿瘤 ？ 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 The progress of coronary atherosclerosis Plaque rupture resulting myocardium infarction Courtesy of Dr. Wei Li-xin. PLA General Hospital, China The vulnerable plaque without lumen stenosis The aids of coronary CT imaging: detect the vulunerable plaque before rupture Courtesy of Dr. Wei Li-xin. PLA General Hospital, China CT发现冠脉斑块的敏感度PLAQUE DETECTION：MDCT VS. IVUS 83 segments in 22 patients Sensitivity plaque per segment: 94%(all) 16-slice CT 53%(non-calcified) Achenbach et al: Circulation 2003 ---------------------------------------------------------------------------------------------- 58 vessels in 37 patients Sensitivity plaque detection: 85%(all) 16-slice CT 82%(non-calcified) Laber et al. JACC 2004 ---------------------------------------------------------------------------------------------- 32 vessels in 18 patients Sensitivity plaque d