16层螺旋CT冠状动脉成像的临床应用价值

Application of 16-slice Spiral Computed Tomography in Angiography of Coronary Artery

[目的]评价16层螺旋CT诊断冠心病的临床价值。[方法]对本院67例临床疑诊或确诊的冠心病患者同时行16层螺旋CT冠状动脉血管成像（MSCTA）和冠状动脉造影（CAG）,以CAG为金标准,对照二者符合率。采用经肘静脉用双管高压注射器以3.5 mL/s注入优维显70-95 mL后再注入20 mL生理盐水,在心电图R-R不同间期重建冠脉轴位图像,并行容积成像、曲面重建等后处理。[结果]67例中,冠脉造影示明显狭窄27例,40例正常。16层MSCTA诊断冠脉中度以上狭窄敏感性81.5%（22/27）,特异性90.0%（36/40）,阳性预测值84.6%（22/26）,阴性预测值87.8%（36/41）,准确性86.6%（58/67）。[结论]16层MSCTA简便、安全,其较高质量CTA图像可作为冠心病筛选、冠脉术前评价和术后复查的重要手段。

[Objective] To evaluate the clinical value of 16-slice spiral CT in the diagnosis of coronary heart disease（CHD）.[Methods] Sixty seven patients underwent both 16-slice spiral CT scanning and routine coronary angiography（MSCTA） from October 2006 to February 2008,and the results of the both methods were compared.GE Light-speed 16-slicesspiral CT machine was used.Iopromide（Ultravist） 70-95 mL was administered via elbow vein at a speed of 3.5ml/s.Axis images of coronary artery were reconstructed at different R-R interval of ECG.Some post-treatments were conducted involving VRT（volume rendering,VR） and CPR（curved planar reformation,CPR）.[Results] Twenty-seven patients had significant coronary artery stenosis and forty patients had normal coronary angiography.By referring to routine angiography as gold standard,16-slice MSCTA had a sensitivity rate of 81.5% and specificity rate of 90.0% in diagnosing narrowness severer than moderate,and the positive and negative estimate was 84.6% and 87.8%,respectively,and the accuracy was 86.6%.[Conclusion]16-slice MSCTA as a simple,reliable and noninvasive examination is a valuable method in the screening for suspected coronary artery disease and for pre-and post-operative examination.