16层螺旋计算机体层摄影术对冠状动脉疾病的诊断价值

Diagnostic value of 16-slice spiral computed tomography for dete cting coronary artery disease

目的:探讨16层螺旋计算机体层摄影术(以下简称16层螺旋CT)冠状动脉成像技术的应用和临床价值。方法:2 0 0例临床诊断或可疑冠心病的患者(2 9例行冠状动脉成形术及支架植入术,2例行冠状动脉造影)做16层螺旋CT冠状动脉成像检查(回顾性心电门控,0 .5 S螺旋扫描) ,分析16层螺旋CT对冠状动脉的显示能力,并分析管壁钙化和软性斑块,评价16层螺旋CT预测冠心病危险性的价值。结果:在2 1例患者的15 2个节段(血管直径≥2 m m)中,CT图像能满足诊断要求的136节段(占83.9% )。对于CT图像能满足诊断要求的冠状动脉节段,16层螺旋CT显示中度或中度以上狭窄的敏感度和特异度分别为87.0 % (2 7/ 31)和96 .2 % (10 1/ 10 5 )。若将不能满足诊断要求的14个节段包括在内,则16层螺旋CT中度或中度以上狭窄的敏感度为80 .0 % (2 7/ 35 )。此外,16层螺旋CT对冠状动脉钙化和软性斑块显示良好,对支架显示良好。结论:在冠状动脉中高度狭窄的诊断上,16层螺旋CT冠状动脉造影是一种有效的无创性诊断方法,可良好的显示冠状动脉软斑块和钙化。

Objective:To investigate the application and clinic al value of Multislice spiral X-ray computed tomography (MSCT,sixteen-slice)coronary angiography.Methods:A total of 70 consecutive patients with known or suspected coronary artery disease(including 29 cases of coronary artery angioplasty and vessel stent,21 cases of coronary angiography)were studied by 16-slice spiral CT(retrospectively ECG-gating.0.5 s ratation).The coronary artery vessels displaying ability of 16-slice spiral CT was analyzed.Whether there are calcifications and vulnerable plaques in vessel walls were analyzed either.To evaluate the value of 16-slice spiral CT in prediction of gravity about coronary artery disease.Results:In the 152 coronary artery segments(vessel diameter≥2mm) of 16-slice spiral CT in 21 patients,136 were judged to be evaluable by 16-slice spiral CT(89.3%).The sensitivity and specificity for the detection of ≥50% stenosis were 87.0% and 96.2%,respectively.When 14 coronary artery segments jundged unevaluable were included in the analysis the sensitivity was 80.0%.Futhermore 16-slice spiral CT shows a good method in displaying coronary artery calcification,vulnerable plaques and coronary artery stent.Conclusion:It could be used in noninvasive assessment of significant coronary artery stenosis with high accuracy.16-slice spiral CT shows a good method in displayiny coronary artery vulnerable plaques and calcificatioin.It might be a method of choice for gravity o f patients with coronary artery disease.