多层螺旋CT冠脉成像诊断冠心病的价值探讨

Non-invasive multislice spiral computed tomography angiography in diagnosis of coronary artery disease: an effective filter?

目的探讨多层螺旋CT冠脉造影(MSCTA)对冠心病(CAD)的诊断价值。方法对临床拟诊冠心病的55例病人行MSCTA,并与导管法冠脉造影(CAG)作对照。以管腔狭窄≥50%为CAD的诊断标准,CT值≥120HU定义为钙化斑块。结果55例患者220支冠脉血管中有204支(92.7%)血管能够满足冠脉评价要求。其诊断CAD总体敏感性、特异性、阳性预测值、阴性预测值及准确性分别为81.6%、87.1%、66.7%、93.8%、85.8%。钙化斑块组的CT值(387.34-448.1HU)明显高于非钙化斑块(64.38±87.36)HU(P<0.01)。结论MSCTA对CAD的初步诊断显示出良好临床价值,可作为CAD高危人群以及介入治疗前的一种筛查手段。MSCT可结合密度测定判定斑块的性质,对判断冠脉斑块的稳定性具有重要的临床意义。

Objective To investigate the clinical diagnostic value of the muttislice spiral computed tomography angiography （MSCFA） for coronary artery disease （CAD） .Methods 55 patients with suspected CAD undergoing catheter coronary angiography were enrolled for MSCTA.The stenosis of≥50% diameter reduction was taken as the diagnostic standard of CAD. Density≥ 120HU was defined a calcified coronary atherosclemtic plaque. Results In the 220 coronary artery segments of 55 patients, 204 were satisfied to evaluate by MSCrA（92.7% ）. The global sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 81.6%, 87.1%, 66.7%, 93.8% and 85.8 %, respectively. The CT density of the group of calcified plaques （387.3±448.1HU ） were significantly higher than that of non - calcified plaques. （64.38 ± 87.36HU） （P〈0.01）. Conchusion MSCTA shows a favorable value in the primary diagnosis for CAD. It can be acted as an effective filter procedure for the high - risk person with CAD and before the intervention. MSCTA is able to assess the character of the plaque with detection of CT density.