目的 应用128层螺旋CT冠状动脉成像，探讨冠状动脉不同成分斑块与狭窄程度的诊断价值。 方法 对2010年3月－2012年10月150例临床拟诊冠心病及确诊冠心病患者的128层螺旋CT冠状动脉成像检查，冠状动脉影像表现由两位心血管CT诊断医师独立判断冠状动脉斑块成分及测量冠状动脉狭窄程度。应用Circulation血管分析软件，分析冠状动脉斑块成分与狭窄程度之间的相关性。 结果 150例患者中，共发现319处斑块，其中软斑块104处，纤维、混合斑块103处，钙化斑块112处。冠状动脉轻度狭窄114处中，钙化斑块86处 （75.4%）；冠状动脉中度狭窄113处中，纤维、混合斑块75处（66.3%）；冠状动脉重度狭窄92处中，软斑块68处（73.9%）。 结论 128层螺旋CT冠状动脉成像能够有效检测患者冠状动脉斑块的成分及准确判断冠状动脉狭窄程度。
【摘要】 目的 探索腹部淋巴结结核在多层螺旋CT（multi-layered screw CT，MSCT）扫描中CT值动态变化规律。 方法 2007年1月—2010年8月，收集经诊断性治疗或诊断性活检确诊的17例患者腹部淋巴结结核，记录肿大淋巴结数量、大小、位置，测量兴趣淋巴结中心、次中心、边缘部平扫及注药后20、60、120、180、360 s的CT值。 结果 共检测出肿大淋巴结269个，主要分布在肝十二指肠韧带、门腔间隙、肝胃韧带、肠系膜根部和腰3平面以上腹主动脉周围，CT值（49.2±13.6） Hu；强化淋巴结215个，选择21个兴趣淋巴结，测得注药20、60、120、180、360 s后强化区CT值分别为（67.7±15.3）、（75.2±14.6）、（76.3±18.7）、（75.6±13.4）、（72.6±17.4） Hu。 结论 腹部淋巴结结核动态CT值表明动脉期明显强化，静脉期及延时扫描强化值维持在动脉期水平呈平台样改变，反映了淋巴结结核慢性感染的病理状态。【Abstract】 Objective To explore the changing rule of dynamic CT values for abdominal lymph node tuberculosis in multi-layered screw CT (MSCT) multiphasic scanning. Methods Between January 2007 and August 2010, 17 cases of abdominal lymph node tuberculosis confirmed by diagnosis treatment or diagnosis biopsy were retrospectively analyzed. The quantity, size and position of the lymph nodes were recorded, and CT plain scanning values of the interested lymph node center, subcenter, and the margin of the node, and the CT values 20, 60, 120, 180 and 360 seconds after drug administration were also measured. Results Enlargement was found in 269 lymph nodes which were mainly distributed in the liver duodenum ligament, the gate cavity gap, the hepatogastric ligament, the mesentery root and the nodes in retroperitoneal space above the third lumbar vertebra. The average CT value was (49.2±13.6) Hu. A total of 215 lymph nodes had strengthened manifestations, and 21 interested lymph nodes were chosen for the study. The average CT values for lymph nodes with strengthened manifestations 20 ,60, 120, 180, and 360 seconds after drug administration were respectively (67.7±15.3), (75.2±14.6), (76.3±18.7), (75.6±13.4), and (72.6±17.4) Hu. Conclusion Dynamic CT value of abdominal lymph node tuberculosis shows a strengthening in the arterial phase, and the values in the the venous phase and the delayed phase maintain at the arterial phase level, and do not change, which indicates a pathological state of chronic infection of the lymph node tuberculosis.