16层螺旋CT冠状动脉成像临床应用评价

Evaluation of clinical application of 16-slice spiral CT in visualization of coronary artery

目的探讨16层多层螺旋CT(MSCT)冠状动脉成像的临床应用价值。方法对80例(60例临床确诊或疑有冠心病,20例为45岁以上干部体检)行16层MSCT冠脉成像检查,其中10例作了导管法冠脉造影对照。对冠脉各节段显示数量以及有无病变等进行统计、分析,评价16层MSCT冠脉成像对≥50%血管狭窄的敏感性、特异性、阳性预测值与阴性预测值。结果80例共显示774个≥2mm的节段,有87个节段显示不同程度狭窄,185个节段有不同程度动脉粥样硬化斑块。在同时作了冠脉DSA对照的10例中,16层MSCT冠脉成像对≥50%狭窄的敏感性、特异性、阳性预测值和阴性预测值分别为84.6%、98.8%、91.7%和97.7%。结论16层MSCT冠脉成像简便、安全、易行,特别适于门诊患者以及特殊人群的普查;对于介入手术筛选和术后复查,可以部分取代导管法冠脉造影。

Objectiv To study the value of clinical application of 16-slice spiral CT in visualization of coronary artery. Methods Eighty cases underwent 16-MSCT coronary artery visualization, selective coronary artery angiography was performed in 10 of 80 cases （60 cases diagnosed or suspected to have coronary heart disease and 20 cases were physical examination）, In all cases, visibility of coronary artery segments was counted and analyzed, vessel diameter reduction≥50% was difined as significant stenosis. The results of the 16-MSCT visualization were compared with DSA. The sensitivity, specificity, positive and negative predictive value were evaluated. Results In 80 cases, 774 segements of coronary artery which the diameter≥2mm were displayed, and 87 of 774 segements were found stenosis, 185 of 774 segements were found atherosclerosis. The sensitivity, specificity, positive and negative predictive value of 16-MSCT coronary artery visualization were 84.6%, 98.8%, 91.7% ,and 97.7% respectively. Conclusion The visualization of coronary artery with 16-MSCT is a easy and safe method. Especially,the method is suitable for to outpatients and physical examination of special people, and may replace partly conventional coronary artery angiograghy.