16层螺旋CT诊断冠心病的临床研究

16-Detector spiral CT for diagnosing coronary artery disease

目的:评价16层螺旋CT对冠状动脉血管狭窄节段的显示能力。方法:入选15例临床疑似冠心病的患者,进行16层螺旋CT冠状动脉成像。记录患者12导联静息心电图,根据ST-T有改变的导联推测相关狭窄的冠状动脉。患者于螺旋CT检查后1周内行冠状动脉造影,以之为标准,观察16层螺旋CT和心电图对于狭窄程度≥50%的冠脉血管诊断的准确性。结果:16层螺旋CT冠状动脉成像对于≥50%狭窄的血管分支检出的敏感度为71.43%,特异度为97.69%,阳性预测值为83.33%,阴性预测值为96%,与冠脉造影的一致性较好。CT和心电图联合应用对冠脉狭窄节段的检出能力无提高。结论:16层螺旋CT冠状动脉成像对于冠状动脉有较好的显示能力;对于冠状动脉狭窄性病变的识别能力可靠,但与心电图联合应用对冠脉狭窄的诊断无进一步帮助。

Objective To assess the visibility of coronary artery stenosed segments detected with 16-detector spiral CT. Methods Fifteen patients with suspected coronary artery disease were enrolled and 16-detector spiral CT was performed in all patients. All patients were recorded and analyzed with 12-lead resting electrocardiogram. The correlative stenosed coronary arteries were speculated by observing the change of ST-T segments from ECG. These patients performed coronary angiography within 1 week and the results were regarded as the criterion. The diagnosis accuracy of 16-detector spiral CT and ECG for detecting coronary arteries stenosed ≥ 50% were observed. Results The sensitivity, specificity, positive and negative predictive value of 16-detector spiral CT with coronary angiography were 71. 43%, 97. 69%, 83. 33% and 96% for coronary arteries stenosed ≥ 50% respectively. The coherence between 16- detector spiral CT coronary imaging and coronary angiography was good. The detected ability of CT and ECG wasn＇t improved for coronary arteries stenosed ≥50%. Conclusion Good coronary artery visibility can be acquired with 16-detector spiral CT. The identify ability of 16-detector spiral CT for stenosis lesion of coronary artery is reliable. It is no more benefit for diagnosis when CT is combined with ECG.