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目的分析冠脉狭窄临床诊断应用64层螺旋CT图像后处理技术的方法与价值。方法以我院放射科2013年6月—2014年6月接收的41例冠脉狭窄患者为对象,行64排螺旋CT增强扫描,通过曲面重建(CPR)、多平面重建(MPR)、最大密度投影法(MIP)、容积显示技术(VR)技术对所得图像进行重建,诊断分析狭窄部位,并对比分析不同处理技术下的诊断结果。结果在冠脉不同程度狭窄判定的敏感性与特异性上,多平面重建、曲面重建均达到了90%以上,但对于复杂的空间结构则难以显示;最大密度投影法容易漏诊较小的斑块;容积显示技术图像在冠脉狭窄特别是重度狭窄与闭塞的血管判定上呈现出较低的敏感性,但却具有立体直观和准确逼真的图像;这几种后处理技术得出的图像均具有超过92%的较高阴性预测值。结论在冠脉狭窄的显示上,64层螺旋CT图像后处理技术的应用有着不同的优势,在分析图像的过程中可相互结合起来,从而更为明确地诊断出冠脉狭窄情况。
Objective To analyze the method and value of post-processing technique of 64-slice spiral CT in clinical diagnosis of coronary artery stenosis. Methods Forty-one patients with coronary artery stenosis who were admitted to our hospital from June 2013 to June 2014 were enrolled in this study. They were scanned with 64-slice spiral CT, and were analyzed by surface reconstruction (CPR), multiplanar reconstruction (MPR), maximum density Projection method (MIP) and Volume Display Technology (VR) were used to reconstruct the images and diagnose and analyze the stenosis. The diagnostic results under different treatment techniques were compared and analyzed. Results The sensitivity and specificity of coronary stenosis were more than 90% for multiplanar reconstructions and curved surfaces, but it was difficult to display for complicated spatial structures. Larger density projection method could easily miss smaller plaques ; Volumetric display technology images in the coronary stenosis, especially severe stenosis and occlusion of blood vessels showed lower sensitivity, but with stereoscopic and accurate realistic images; these post-processing techniques have the image of More than 92% of the higher negative predictive value. Conclusion The application of 64-slice spiral CT image postprocessing has different advantages in the display of coronary artery stenosis. It can be combined with each other in the process of image analysis to diagnose coronary stenosis more clearly.