西门子双源CT冠状动脉成像对冠状动脉狭窄的诊断价值

Diagnostic value of Siemens dual source CT coronary angiography in diagnosis of coronary artery stenosis

目的:探讨西门子双源CT冠状动脉成像对不同狭窄程度冠状动脉的诊断价值。方法:对100例疑诊为冠心病(CHD)患者分别进行双源CT冠状动脉成像(DSCTCA)和冠状动脉造影(CAG)检查,对DSCTCA检查图像质量进行Frank评分,计算DSCTCA对不同狭窄程度冠状动脉的敏感性、特异性、阳性预测值、阴性预测值和准确率,评价DSCTCA和CAG对冠状动脉狭窄的一致性。结果:100例患者均顺利完成DSCTCA和CAG检查,CAG共采集可评价血管1 351段,DSCTCA均可评估。100例患者DSCTCA图像质量均可用于诊断,其中4分79例,3分17例,2分4例,1分0例;DSCTCA评价冠状动脉轻度狭窄的敏感性、特异性、阳性预测值、阴性预测值和准确率分别为85.9%、97.8%、90.6%、98.1%和96.3%,中度狭窄的敏感性、特异性、阳性预测值、阴性预测值和准确率分别为93.6%、99.8%、99.1%、98.5%和98.5%,重度狭窄的敏感性、特异性、阳性预测值、阴性预测值及准确率分别为92.7%、100%、100%、99.2%和99.3%;DSCTCA与CAG评估冠状动脉一致性良好K=0.862(>0.75)。结论:西门子双源CT冠状动脉成像可清晰描述冠状动脉系统的情况,对冠状动脉狭窄的诊断具有较高的准确率。

Objective： To investigate the diagnostic value of Siemens dual source CT coronary angiography（ DSCTCA） in diagnosis of coronary artery stenosis. Methods： 100 suspected patients of coronary heart disease（ CHD） underwent DSCTCA and coronary angiography（ CAG） examination,the image quality of the DSCTCA was given a Frank score,calculated the sensitivity,specificity,positive predictive value,and negative predictive value and accuracy of DSCTCA for different degrees of coronary artery stenosis,evaluated the consistency of DSCTCA and CAG for coronary artery stenosis. Results： 100 patients successfully completed DSCTCA and CAG examination,collected 1 351 segments of the blood vessels can be evaluated by CAG,and all those could be evaluated by DSCTCA. DSCTCA image quality of 100 cases could be used for diagnosis,and 4 points in 79 cases,3 points in17 cases,2 points in 4 cases,1 point in 0 case; DSCTCA evaluation of the sensitivity,specificity,positive predictive value,negative predictive value and accuracy rate of mild stenosis of coronary artery were 85. 9%,97. 8%,90. 6%,98. 1% and 96. 3%. The sensitivity,specificity,positive predictive value,negative predictive value and accuracy rate of moderate stenosis were 93. 6%,99. 8%,99. 1%,98. 5% and 98. 5%. The sensitivity,specificity,positive predictive value,negative predictive value and accuracy rate of severe stenosis were 92. 7%,100%,100%,99. 2% and 99. 3%; DSCTCA and CAG evaluation of coronary artery were in good agreement（ K =0. 862 〉0. 75）. Conclusion： Siemens DSCTCA can describe the coronary artery system clearly,and it has high accuracy in the diagnosis of coronary artery stenosis.