采用256層螺旋CT對冠狀靜脈系統(tǒng)定量研究
發(fā)布時間：2018-08-02 17:55
【摘要】：第一部分采用256層螺旋CT對冠狀靜脈正常解剖結(jié)構(gòu)的評價目的:采用256層螺旋CT定量分析成人正常冠狀靜脈竇解剖結(jié)構(gòu)及顯示率,并分析與性別、年齡的相關(guān)性。方法:選擇200例懷疑臨床冠心病或體檢行256層CT螺旋冠狀動脈CTA檢查的患者,并顯示冠狀動脈無病變,并符合入組條件的患者,其中男性92例,女受檢者108例,平均年齡為(56.35±10.83)歲;對冠脈CTA原始掃描數(shù)據(jù)進(jìn)行心臟舒張期78%時相圖像重建,觀察冠狀靜脈竇(coronary sinus,CS)、后室間靜脈(the Posterior inter—ventricular vein,PIV)、左心室后靜脈(Posterior vein of the left ventricle,PVLV)、左邊緣靜脈(the leftmarginal vein,LMV)、心大靜脈(greatcardiac vein,GCV)、前室間靜脈(anterior inter—ventricular vein,AIV),心小靜脈(small cardiac vein,SCV)、馬歇爾靜脈(Marshall vein)的走行、解剖結(jié)構(gòu)及顯示率,并按照性別分組,分為男性組及女性組;按照年齡分組,分為三組20~40歲,40~60歲,60歲;并觀察冠狀靜脈解剖結(jié)構(gòu)、顯示率與性別、年齡的相關(guān)性。結(jié)果:1心大靜脈(GCV)、冠狀靜脈竇(CS)、后室間靜脈(PIV)、前室間靜脈(AIV)在所有的病例中100%顯示。左心室后靜脈(PVLV)顯示率為90.5%(181/200),左邊緣靜脈(LMV)顯示率為71.5%(144/200),心小靜脈的顯示率為19%(38/200)。2左心室后靜脈(PVLV)與左邊緣靜脈(LMV)匯入點(diǎn)變異較大。3各屬支顯示率與性別無明顯相關(guān)性(P0.05)。4對不同年齡組20~40歲,40~60歲,60歲冠狀靜脈解剖及顯示率比較,三組間差別無明顯統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:采用256層螺旋CT冠狀靜脈成像可以客觀顯示冠狀靜脈走行、解剖及其與周圍組織的關(guān)系,后者為臨床成功實(shí)行心臟介入手術(shù)提供了重要參考價值。第二部分采用256層螺旋ct對冠狀靜脈正常值定量分析目的:采用256層螺旋ct定量測量正常成人冠狀靜脈竇、主要屬支徑線、截面積,并分析與性別、年齡的相關(guān)性。方法:選擇81例可疑冠心病或體檢行256層螺旋冠狀動脈cta檢查并顯示冠狀動脈無病變,并符合入組條件的患者男性37例,女性44例,平均年齡(54.02±13.39)歲;冠脈cta檢查結(jié)果均未發(fā)現(xiàn)冠狀動脈病變及其它心臟疾病的患者,對各患者的原始圖像進(jìn)行多期重建,選取心臟舒張中末期圖像重建,并定量測量冠狀靜脈主要屬支徑線、截面積,并對各測量值與性別、年齡組進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1定量測量心大靜脈(gcv)、冠狀靜脈竇(cs)、后室間靜脈(piv)、左心室后靜脈(pvlv)、左邊緣靜脈(lmv),心小靜脈徑線、截面積,對男女不同性別進(jìn)行比較,兩者差別無統(tǒng)計(jì)學(xué)意義(p0.05);281例患者按照年齡分組分成三組為a(≤45歲)、b(45歲-65歲)、c(≥65歲)三組,心大靜脈(gcv)、冠狀靜脈竇(cs)、后室間靜脈(piv)、左心室后靜脈(pvlv)、左邊緣靜脈(lmv),心小靜脈徑線、截面積定量測量,不同年齡組間進(jìn)行比較,三組間冠狀靜脈及屬支徑線及截面積無明顯差別(p0.05);3冠狀靜脈竇上下徑、面積、直徑、前后徑,后室間靜脈、左室后支靜脈、左邊緣支直徑,后室間靜脈、左室后支靜脈、左邊緣支面積95%參考值范圍分別為:11.67~12.84mm,49.82~72.66mm2,7.85~9.30mm,7.90~9.54mm;2.51~3.37mm,2.90~3.56mm,1.92~2.39mm,5.72~10.31mm,6.86~10.72mm,3.12~4.92mm2。結(jié)論:采用256層螺旋ct冠狀靜脈成像可客觀定量測量冠狀靜脈主要屬支徑線、冠狀靜脈截面積,為臨床成功實(shí)行心臟介入手術(shù)提供了重要影像參考價值。第三部分采用256層螺旋ct對冠狀動脈單支重度狹窄患者冠狀靜脈定量研究目的:應(yīng)用256層螺旋ct對冠狀動脈單支重度狹窄患者冠狀靜脈定量測量,并與正常對照組比較,觀察冠狀動脈疾病與冠狀靜脈系統(tǒng)關(guān)系。方法:回顧性分析在我院進(jìn)行冠狀動脈CTA檢查的121例,對照組64例,所選病例冠狀動脈均無異常,符合入組標(biāo)準(zhǔn);單支冠狀動脈重度狹窄組57例,將所有患者影像原始數(shù)據(jù),進(jìn)行后處理,采用血管分析軟件定量測量心大靜脈(GCV)、冠狀靜脈竇(CS)、后室間靜脈(PIV)、心室后靜脈(PVLV)、左邊緣靜脈(LMV)、心小靜脈(SMV)入口處的口徑與截面積大小,比較冠脈正常組及冠脈狹窄組冠狀靜脈顯示率、冠狀靜脈CT定量數(shù)據(jù),觀察兩組間有無統(tǒng)計(jì)學(xué)差別;同時將病變組按照年齡分組分為兩組60歲與≤60歲兩組,對不同年齡組間進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1冠脈正常組與冠脈狹窄組中,心大靜脈(GCV)、冠狀靜脈竇(CS)、后室間靜脈(PIV)、前室間靜脈(AIV)顯示率均為100%。左心室后靜脈(PVLV)在冠脈正常組與冠脈狹窄組的顯示率分別為93.75%(60/64)、82.46%(47/57);左邊緣靜脈(LMV)在冠脈正常組與冠脈狹窄組的顯示率59.38%(38/64)、63.16%(36/57)。2冠狀靜脈竇(CS)前后徑及上下徑、后室間靜脈(PIV)、左邊緣靜脈(PVLV)入口處的徑線與截面積測量值在冠狀動脈正常組與存在單支冠狀動脈狹窄組間比較無明顯差別(P0.05)。3冠脈狹窄組中60歲以上年齡組的冠狀靜脈竇的前后徑測量值大于≤60歲的年齡(P=0.017),冠狀靜脈竇的上下徑測量值大于≤60歲的年齡組(P=0.001),在冠狀靜脈屬支的截面積及徑線測量中差別無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:采用256層螺旋CT可以客觀顯示冠狀動脈及冠狀靜脈,單支冠狀動脈狹窄對冠狀靜脈顯示及徑線無明顯影響,后者對臨床冠狀靜脈相關(guān)手術(shù)具有重要臨床價值。
[Abstract]:The first part was used to evaluate the normal anatomical structure of coronary vein with 256 slice spiral CT. 256 layers of spiral CT were used to quantitatively analyze the anatomical structure and display rate of normal coronary sinus in adults, and to analyze the correlation with sex and age. Methods: 200 patients with suspected clinical coronary heart disease or 256 layer of CT spiral coronary artery CTA examination were selected. There were no lesions in the coronary artery, and the patients were conformed to the conditions of the group, of which 92 were male and 108 in women, with an average age of (56.35 + 10.83) years. The original coronary CTA scan data were reconstructed for 78% hours of cardiac diastolic phase, and the coronary sinus (coronary sinus, CS) and the posterior interventricular vein (the Posterior inter - ventricular VE) were observed. In, PIV), the left ventricular posterior vein (Posterior vein of the left ventricle, PVLV), the left marginal vein (the leftmarginal vein), the great vein of the heart, the vein of the interventricular vein, the vein of the heart, and the anatomy and display of the Marshall vein. The rates were divided into male and female groups according to gender groups. According to age group, three groups of 20~40 years, 40~60 years old and 60 years old were divided into three groups. The anatomical structure of coronary veins was observed and the correlation between sex and age was observed. Results: 1 heart vein (GCV), coronary sinus (CS), posterior interventricular vein (PIV), and interventricular vein (AIV) in all cases were found in all cases. The rate of left ventricular posterior vein (PVLV) was 90.5% (181/200), the left marginal vein (LMV) showed 71.5% (144/200), and the display rate of the venule of the heart was 19% (38/200).2 left ventricular posterior vein (PVLV) and the left marginal vein (LMV) remittance. There was no significant correlation between the display rate and sex (P0.05).4 (P0.05).4 on the different age groups. There was no significant difference between the three groups at the age of 60 years. There was no significant difference between the three groups (P0.05). Conclusion: the use of 256 slice spiral CT coronary vein imaging can objectively show the coronary vein, dissection and its relationship with the surrounding tissue. The latter provides an important reference value for the successful implementation of cardiac interventional operation. Second parts. Quantitative analysis of the normal coronary vein by 256 slice spiral CT: 256 layers of spiral CT were used to measure the coronary sinus of normal adults, the main branch line, the sectional area, and the correlation with sex and age. Methods: 81 cases of suspected coronary artery disease or physical examination were selected for 256 spiral coronary artery CTA examination and showed no coronary artery disease. There were 37 male patients and 44 women with an average age of (54.02 + 13.39) years of age. No coronary artery lesions and other heart diseases were found in the coronary CTA examination. The original images of the patients were rebuilt, the end diastolic image reconstruction was selected, and the main branch line of the coronary vein was measured. Cross-sectional area, and statistical analysis of the measured values and sex, age group. Results: 1 GCV, CS, posterior interventricular vein (PIV), left ventricular posterior vein (pvlv), left marginal vein (LMV), small vein line of the heart, cross sectional area were compared, and there was no statistical difference between the two sexes (P0.05); (P0.05); The patients were divided into three groups according to age group: a (< 45 years old), B (45 year old -65 years), three groups of C (65 years old), cardiac vein (GCV), coronary sinus (CS), posterior interventricular vein (PIV), left ventricular posterior vein (pvlv), left marginal vein (LMV), small vein diameter of heart, comparison between different age groups, coronary veins and branch diameter between the three groups There was no significant difference between line and section area (P0.05); 3 the upper and lower diameter of coronary sinus, area, diameter, anterior and posterior diameter, posterior interventricular vein, left posterior branch vein, left marginal branch diameter, posterior interventricular vein, left posterior vein, and left marginal branch area of 95% reference range were respectively: 11.67~ 12.84mm, 49.82~72.66mm2,7.85~9.30mm, 7.90~9.54mm; 2.51~3.37mm, 2.90~3.56mm 1.92~2.39mm, 5.72~10.31mm, 6.86~10.72mm, 3.12~4.92mm2. conclusion: 256 slice spiral CT coronary vein imaging can be used to objectively and quantitatively measure the main branch line of the coronary vein, the coronary vein section area, and provide the important image reference value for the successful implementation of cardiac interventional operation. The third part uses 256 slice spiral CT to single coronary artery. Coronary vein quantitative study in severe stenosis patients: quantitative coronary vein measurement with 256 slice spiral CT for patients with severe coronary artery stenosis, and compared with normal control group, the relationship between coronary artery disease and coronary vein system was observed. Methods: retrospective analysis of 121 cases of coronary artery CTA examination in our hospital and 64 cases in control group. There were no abnormal coronary arteries in the selected cases, which were in line with the standard of entry group; 57 cases of single coronary artery stenosis group were treated with the original data of all the patients. The large vein (GCV), the coronary sinus (CS), the posterior interventricular vein (PIV), the posterior ventricular vein (PVLV), the left marginal vein (LMV), and the venule (SMV) were measured by the software of blood vessel analysis. The diameter of the entrance and the size of the sectional area were compared with the coronary venous display rate of the normal coronary artery and the coronary stenosis group and the quantitative data of the coronary vein CT. There were no statistical differences between the two groups. At the same time, the group was divided into two groups, 60 and 60 years old and two groups according to the age group, and the results were statistically analyzed between the groups of different age groups. Results 1 the normal coronary artery group and the normal group were analyzed. In the coronary stenosis group, the cardiac vein (GCV), the coronary sinus (CS), the posterior interventricular vein (PIV) and the interventricular vein (AIV) showed the 100%. left ventricular posterior vein (PVLV) in the normal coronary and coronary stenosis groups, respectively, 93.75% (60/64), 82.46% (47/57), and the left marginal vein (LMV) was 59.3 in the normal coronary and coronary stenosis group. 8% (38/64), 63.16% (36/57).2 (36/57).2 coronary sinus (CS) diameter and upper and lower diameter, posterior interventricular vein (PIV), left marginal vein (PVLV) at the entrance of the diameter and cut area measured between the normal coronary artery group and the existence of single coronary stenosis group no significant difference (P0.05).3 coronary stenosis group in the group of 60 years of age over 60 years of age group coronary sinus The measured values of the anterior and posterior diameter were greater than the age of 60 years (P=0.017). The measurements of the upper and lower diameters of the coronary sinus were greater than those of the age group of 60 years (P=0.001). There was no significant difference in the measurement of the sectional area and diameter of the coronary vein branch (P0.05). Conclusion: the 256 slice spiral CT can be used to objectively display the coronary and coronary veins and single coronary artery. Stenosis has no significant effect on coronary vein display and diameter, and the latter has important clinical value for clinical coronary vein related surgery.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R816.2
本文編號：2160219
[Abstract]:The first part was used to evaluate the normal anatomical structure of coronary vein with 256 slice spiral CT. 256 layers of spiral CT were used to quantitatively analyze the anatomical structure and display rate of normal coronary sinus in adults, and to analyze the correlation with sex and age. Methods: 200 patients with suspected clinical coronary heart disease or 256 layer of CT spiral coronary artery CTA examination were selected. There were no lesions in the coronary artery, and the patients were conformed to the conditions of the group, of which 92 were male and 108 in women, with an average age of (56.35 + 10.83) years. The original coronary CTA scan data were reconstructed for 78% hours of cardiac diastolic phase, and the coronary sinus (coronary sinus, CS) and the posterior interventricular vein (the Posterior inter - ventricular VE) were observed. In, PIV), the left ventricular posterior vein (Posterior vein of the left ventricle, PVLV), the left marginal vein (the leftmarginal vein), the great vein of the heart, the vein of the interventricular vein, the vein of the heart, and the anatomy and display of the Marshall vein. The rates were divided into male and female groups according to gender groups. According to age group, three groups of 20~40 years, 40~60 years old and 60 years old were divided into three groups. The anatomical structure of coronary veins was observed and the correlation between sex and age was observed. Results: 1 heart vein (GCV), coronary sinus (CS), posterior interventricular vein (PIV), and interventricular vein (AIV) in all cases were found in all cases. The rate of left ventricular posterior vein (PVLV) was 90.5% (181/200), the left marginal vein (LMV) showed 71.5% (144/200), and the display rate of the venule of the heart was 19% (38/200).2 left ventricular posterior vein (PVLV) and the left marginal vein (LMV) remittance. There was no significant correlation between the display rate and sex (P0.05).4 (P0.05).4 on the different age groups. There was no significant difference between the three groups at the age of 60 years. There was no significant difference between the three groups (P0.05). Conclusion: the use of 256 slice spiral CT coronary vein imaging can objectively show the coronary vein, dissection and its relationship with the surrounding tissue. The latter provides an important reference value for the successful implementation of cardiac interventional operation. Second parts. Quantitative analysis of the normal coronary vein by 256 slice spiral CT: 256 layers of spiral CT were used to measure the coronary sinus of normal adults, the main branch line, the sectional area, and the correlation with sex and age. Methods: 81 cases of suspected coronary artery disease or physical examination were selected for 256 spiral coronary artery CTA examination and showed no coronary artery disease. There were 37 male patients and 44 women with an average age of (54.02 + 13.39) years of age. No coronary artery lesions and other heart diseases were found in the coronary CTA examination. The original images of the patients were rebuilt, the end diastolic image reconstruction was selected, and the main branch line of the coronary vein was measured. Cross-sectional area, and statistical analysis of the measured values and sex, age group. Results: 1 GCV, CS, posterior interventricular vein (PIV), left ventricular posterior vein (pvlv), left marginal vein (LMV), small vein line of the heart, cross sectional area were compared, and there was no statistical difference between the two sexes (P0.05); (P0.05); The patients were divided into three groups according to age group: a (< 45 years old), B (45 year old -65 years), three groups of C (65 years old), cardiac vein (GCV), coronary sinus (CS), posterior interventricular vein (PIV), left ventricular posterior vein (pvlv), left marginal vein (LMV), small vein diameter of heart, comparison between different age groups, coronary veins and branch diameter between the three groups There was no significant difference between line and section area (P0.05); 3 the upper and lower diameter of coronary sinus, area, diameter, anterior and posterior diameter, posterior interventricular vein, left posterior branch vein, left marginal branch diameter, posterior interventricular vein, left posterior vein, and left marginal branch area of 95% reference range were respectively: 11.67~ 12.84mm, 49.82~72.66mm2,7.85~9.30mm, 7.90~9.54mm; 2.51~3.37mm, 2.90~3.56mm 1.92~2.39mm, 5.72~10.31mm, 6.86~10.72mm, 3.12~4.92mm2. conclusion: 256 slice spiral CT coronary vein imaging can be used to objectively and quantitatively measure the main branch line of the coronary vein, the coronary vein section area, and provide the important image reference value for the successful implementation of cardiac interventional operation. The third part uses 256 slice spiral CT to single coronary artery. Coronary vein quantitative study in severe stenosis patients: quantitative coronary vein measurement with 256 slice spiral CT for patients with severe coronary artery stenosis, and compared with normal control group, the relationship between coronary artery disease and coronary vein system was observed. Methods: retrospective analysis of 121 cases of coronary artery CTA examination in our hospital and 64 cases in control group. There were no abnormal coronary arteries in the selected cases, which were in line with the standard of entry group; 57 cases of single coronary artery stenosis group were treated with the original data of all the patients. The large vein (GCV), the coronary sinus (CS), the posterior interventricular vein (PIV), the posterior ventricular vein (PVLV), the left marginal vein (LMV), and the venule (SMV) were measured by the software of blood vessel analysis. The diameter of the entrance and the size of the sectional area were compared with the coronary venous display rate of the normal coronary artery and the coronary stenosis group and the quantitative data of the coronary vein CT. There were no statistical differences between the two groups. At the same time, the group was divided into two groups, 60 and 60 years old and two groups according to the age group, and the results were statistically analyzed between the groups of different age groups. Results 1 the normal coronary artery group and the normal group were analyzed. In the coronary stenosis group, the cardiac vein (GCV), the coronary sinus (CS), the posterior interventricular vein (PIV) and the interventricular vein (AIV) showed the 100%. left ventricular posterior vein (PVLV) in the normal coronary and coronary stenosis groups, respectively, 93.75% (60/64), 82.46% (47/57), and the left marginal vein (LMV) was 59.3 in the normal coronary and coronary stenosis group. 8% (38/64), 63.16% (36/57).2 (36/57).2 coronary sinus (CS) diameter and upper and lower diameter, posterior interventricular vein (PIV), left marginal vein (PVLV) at the entrance of the diameter and cut area measured between the normal coronary artery group and the existence of single coronary stenosis group no significant difference (P0.05).3 coronary stenosis group in the group of 60 years of age over 60 years of age group coronary sinus The measured values of the anterior and posterior diameter were greater than the age of 60 years (P=0.017). The measurements of the upper and lower diameters of the coronary sinus were greater than those of the age group of 60 years (P=0.001). There was no significant difference in the measurement of the sectional area and diameter of the coronary vein branch (P0.05). Conclusion: the 256 slice spiral CT can be used to objectively display the coronary and coronary veins and single coronary artery. Stenosis has no significant effect on coronary vein display and diameter, and the latter has important clinical value for clinical coronary vein related surgery.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R816.2
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