多层螺旋CT对冠状动脉钙化的定量分析及临床意义

Clinical significance of multislice spiral CT in quantitative analysis of coronary artery calcium

目的 :评价多层螺旋CT(MSCT)测定冠状动脉钙化积分的准确性及临床意义。方法 :搜集 12 5例在我院行MSCT检查临床怀疑或确诊为冠心病的病例资料。MSCT扫描采用心电门控触发成像 ,单次扫描时间为 0 .3 2s ,层厚为 2mm× 4。钙化灶定义为CT值≥ 13 0HU。其中 2 3例另行冠状动脉造影检查。结果 :12 5例受检者冠状动脉钙化有 92例 ( 73 .6% ) ,各部位发生率依次为左前降支 ( 3 4.9% )、回旋支 ( 3 1.7% )、右冠状动脉 ( 2 7.3 % )和左冠状动脉主干 ( 6.1% ) ;<5 0岁和 5 0～ 65岁冠心病组冠状动脉钙化率、钙化积分明显高于正常组 ,≥ 65岁冠心病组冠状动脉钙化率与正常组无显著差别 ,但钙化积分明显高于正常组。冠脉钙化检测冠心病在年轻组特异性高 ,敏感性低 ,随年龄增大敏感性增高而特异性降低。结论 :多层螺旋CT检出冠状动脉钙化简便易行 ,有较高的敏感性和特异性 ,可广泛用于临床预测及早期诊断冠心病。

Objective:To assess the accuracy and clinical significance of multislice spiral CT (MSCT) scan in quantitative examination of coronary artery calcium (CAC).Methods:125 patients underwent multislice spiral CT (MSCT) examination and coronary angiography was additionally performed in 23 paients of them.Single slice mode with ECG gating was used in MSCT scan with single scan-time of 0.32s and slice thickness of 2mm×4mm.Results:The incident rate of CAC in 125 patients was 73.6%(92/125).The calcification rate of LAD,CX,RCA and LM was 34.9%,31.7%,27.3% and 6.1% respectively.The CAC incidence in age <50 and 50～65 groups was significantly higher than that of the normal group.There was no significant difference in CAC incidence between CHD group and the normal group in age ≥65,but the CAC score of CHD group was remarkable higer than that of the normal group.The specificity of CAC was high and sensitivity was low in the younger group,and the sensitivity would be increased and specificity decreased following increase of age.Conclusion:MSCT is promising in detecting coronary arterial disease,since it has high sensitivity and specificity,easy to conduct,noninvasive,and could be widely applicated for screening a large population.