2018 年第 12 期 第 13 卷

螺旋CT诊断心肌桥最佳成像方法探讨

Optimal imaging method of spiral CT in diagnosis of myocardial bridge

作者：周伟李盖张明剑陈伟彬张惠英

英文作者：

单位：063000河北省唐山市，华北理工大学附属医院CT室

英文单位：

关键词：心肌桥；冠状动脉CT血管造影；壁冠状动脉；图像后处理技术；X线计算机体层摄影术

英文关键词：

• 摘要：

• 【摘要】目的    探讨256层螺旋CT在诊断心肌桥方面的最佳成像方法。方法    选取2015年1月至2018年3月于华北理工大学附属医院行选择性冠状动脉造影及冠状动脉CT血管造影共同确诊心肌桥的患者95例。对患者的仿真内窥镜（VE）、容积再建、最大密度成像（MIP）、曲面再建、多平面再建（MPR）重建图像进行分析，分析各种图像后处理技术在诊断心肌桥方面的差别。结果    各种图像后处理技术中，VE优秀0例、良好0例、差95例(100.0%)，平均秩422.00；容积再建优秀36例(37.8%)、良好54例(56.8%)、差5例(5.4%)，平均秩266.54；MIP优秀90例(94.7%)、良好5例(5.3%)、差0例，平均秩159.09；曲面再建优秀95例(100.0%)、良好0例、差0例，平均秩147.50；MPR优秀73例(76.8%)、良好17例(17.8%)、差5例(5.4%)，平均秩194.87。经秩和检验，5种图像后处理技术组间图像质量差异有统计学意义（χ2=343.57、P<0.05），以曲面再建/MIP图像后处理方法有明显优势。结论    256层螺旋CT多种图像后处理技术中，曲面再建/MIP重建技术为最佳诊断心肌桥的成像方法。

• 【Abstract】Objective    To explore the optimal imaging method of 256-slice spiral CT in diagnosis of myocardial bridge. Methods    From January 2015 to March 2018, 95 patients with myocardial bridge diagnosed by selective coronary angiography and coronary CT angiography were enrolled in the Affiliated Hospital of North China University of Science and Technology. Virtual endoscopy(VE), volume rendering(VR), maximum intensify projection(MIP), curved planar reformation(CPR), multiple planar reformation(MPR) reconstruction images and the diagnostic effectiveness of different image post-processing techniques were analyzed. Results    Among the five image post-processing techniques, VE showed excellent image quality in 0 case, good image quality in 0 case and bad image quality in 95 cases(100.0%); the mean rank was 422.00. VR was excellent in 36 cases(37.8%), good in 54 cases(56.8%) and bad in 5 cases(5.4%); the mean rank was 266.54. MIP was excellent in 90 cases(94.7%) and good in 5 cases(5.3%); the mean rank was 159.09. CPR was excellent in 95 cases(100.0%); the mean rank was 147.50. MPR was excellent in 73 cases(76.8%), good in 17 cases(17.8%) and bad in 5 cases(5.4%); the mean rank was 194.87. Rank-sum test showed that there were significant differences of image quality among the five post-processing techniques（χ2=343.57, P<0.05）; CPR/MIP had obvious advantages. Conclusion    CPR/MIP reconstruction is the best method of 256-slice spiral CT in diagnosis of myocardial bridge.