<正>随着人口老龄化社会的到来,心脏病变在老年中发病率所占比例也越来越高,而冠心病是动脉粥硬化导致脏器损害的最常见类型,是严重危害人类康的常见病[1]。双源CT是一项最新技术,其极高图像时间空间分辨率,使其成为心脏冠状动脉检查好的无创影像方法。目前被认为是可准确评价冠动脉的无创手段[2,3]。其快速、清晰的扫描特点在用于老年冠心病患者的临床检查时,可以明显减少心率、心律不齐或呼吸伪影造成的冠状动脉伪影,

目的探讨双源CT应用钆喷酸二葡甲胺对不适用碘对比剂患者冠状动脉成像的可能性。方法分析了30例怀疑冠状动脉病变患者行钆喷酸二葡甲胺双源CT冠状动脉成像的图像质量和冠状动脉病变。结果 30例患者均可见冠状动脉主干及其分支的强化,增强效果优秀7例,增强效果好21例,增强效果欠佳2例。5例可见非钙化斑块或者钙化,并可见冠状动脉管腔狭窄征象,冠状动脉起源异常1例,冠状动脉-肺动脉瘘1例,肌桥18例。结论对于不适用碘对比造影剂的患者,怀疑冠状动脉病变时,在肾功能情况良好的前提下,可以利用钆喷酸二葡甲胺进行双源CT冠状动脉成像。

Purpose:To explore the clinical values of dual-source CT(DSCT)in diagnosis of complex congenital heart disease(CCHD)in neonates and infants.Materials and Methods:Eighteen patients(age range,7days～20 months)with CCHD were underwent cardiac imaging with a dual-source CT scanner. Two-and three-dimensional images were reformated by means of MPR(coronal,sagital and oblique), MIP and VR.Echocardiography was performed in all cases at same time,cardioangiography in 1 case, and 8 patients finally were treated with surgery.Results:DSCT revealed 90 anomalies and echocardiog- raphy revealed 65 in all 18 cases.Among the 50 anomalies proved by operation and cardioangiography in 9 patients,DSCT detected 14/16,3/3,30/31 of intracardic anomalies,abnomal connection of atrium or ventricle to great vessels and vessel anomalies,meanwhile echocardiography detected 16/16,3/3,17/31 respectively.The combination of DSCT and echocardiography could raise the diagnostic accuracy to 98%. Conclusion:As non-invasive imaging technique,DSCT is equal or superior to echocardiography in de- tecting anomalies of CCHD in neonates and infants,especially in revealing vessel anomalies.The com- bination of two techniques can avoid invasive cardioangiography in most cases of CCHD.

在CT增强扫描中,应用碘造影剂可引起程度不一的不良反应,但引起急性溶血性贫血罕见,我们遇到 1例,现报告如下.