64层螺旋CT冠状动脉成像质量及对冠状动脉疾病的诊断价值(附562例应用体会)

The clinical values of coronary artery imaging with 64-slice spiral CT

目的:评价64层螺旋CT冠状动脉成像(64SCTCA)在诊断冠状动脉疾病中的临床价值。方法:收集562例临床可疑冠心病患者SCTCA的完整资料,其中48例与近期选择性X线冠状动脉成像(CCA)结果进行了对照分析,并对64层SCTCA显示的冠状动脉主干及主要分支情况进行了分级评估。结果:562例患者中有48例经CCA证实,48例720个节段中有687个节段可做定量评价,SCTCA发现98个节段有狭窄,CCA发现92个节段有狭窄,SCTCA诊断狭窄的敏感性为94.5%,特异性为98.1%,阳性预测值为88.7%,阴性预测值为99.2%。结论:64SCTCA对于冠状动脉狭窄的评估具有较高敏感性和特异性,适用于冠心病的筛查,具有重要的临床价值。

Objective： To evaluate the diagnostic accuracy for the assessment of coronary artery diseases with 64-slice CT coronary angiography. Methods： Totally 562 patients suspected of coronary artery diseases （CAD） were examined by 64-slice spiral CT, 48 of them also compared with conventional coronary angiography（CCA） regarded as the gold standard. The visibility of coronary branches was evaluated. The left main artery（LM）, left anterior descending artery（LAD）, circumflex artery（CX）, and right coronary artery （RCA） were screened for the presence of over 50% stenosis. Results： Among the 562 patients, 48 patients were consisted with CCA. 720 coronary arteries of them can be detected. 687 coronary segments were applied for quantitative analysis. Ninty-eight lesions were found by SCTCA, 92 lesions were found by CCA. The sensitivity, specificity, positive predict values and negative predict values were 94.5%, 98.1%, 88.7%, and 99.2% respectively for the detection of coronary artery stenosis with SCTCA. Conclusion： 64-slice CTCA has excellent sensitivity and specificity in detecting coronary artery stenosis, h is a useful non-invasive method for screening coronary artery diseases, an important role in clinical diagnosis.