冠状动脉钙化螺旋CT检查与冠脉造影的对比分析

Comparative analysis of thoracic spiral CT and coronary angiography in detection of coronary calcification

目的研究螺旋CT所显示冠状动脉钙化与冠状动脉狭窄之间的关系,并评价其预测冠心病的敏感性及特异性。方法对50例临床疑诊为冠心病的患者,均行螺旋CT检查及冠脉造影,2种方法检查时间间隔<3月。螺旋CT采用层厚为10mm,螺距1.5pitch进行扫描。冠脉造影采用常规的Judkin法。有意义的冠状动脉狭窄指管径缩小>50%。结果钙化在前降支发病率最高,其次为回旋支、右冠脉及左主干。发现钙化的81支血管中,冠脉造影证实有48支狭窄(59.3%);56支血管经冠状动脉造影证实为狭窄,其中85.7%(48支)有钙化。本组总的特异性77.1%,敏感性为85.7%,准确性为62.7%。结论螺旋CT检出冠状动脉钙化简便易行,无创伤性,有较高的敏感性、准确性,可用于临床预测及诊断冠心病。

Objective To investigate the relationship between coronary calcifiction in sprial CT and significant coronary stenosis ,and to explore the value of spiral CT in diagnosing coronary heart disease（CHD） Methods Fifty patients with suspected CHD had both thoracic spiral CT examination and coronary angiography within three months. Spiral CT scan worked by thickniss of 10 mm,and pitch = 1.5. Definition of calcification is density ≥85 HU,area≥1 mm^2. Selected coronary angiography was performed by the Judkins technique. Results Peak incidence rate of calcification is observed in LAD, and others were in the order of LCA,RCA and LMA. Among 81 vessels in which coronary calcification were identified, 59. 3% had significant coronary stenosis（ 〉 50% stenosis） ;85.7% of 56 vessels with singificant coronary stenosis had calcification demonstrable by spiral CT. tn the group the sensitivity of calcification for evaluating coronary stenosis was 85. 7% , and the specificity, accuracy was 77. 1% , 79. 5% respectively. Conclusions Thoracic spiral CT is a promising procedure for detecting coronary arterial disease, since this examination has a high sensitivity and accuracy, easy to conduct, noninvasive, and applicaple for screening a large population.