40层螺旋CT冠状动脉造影诊断冠状动脉狭窄

Comparative Study of 40-slice Spiral CT Coronary Angiograph and Digital Subtraction Coronary Angiograph

目的:评价40层螺旋CT冠状动脉造影诊断冠状动脉明显狭窄的准确性和可行性。材料和方法:78例疑似冠心病患者在3周内进行40层CT冠状动脉造影及经皮选择性冠状动脉造影,以冠状动脉造影结果为金标准对照40层CT诊断冠状动脉主干及主要分支狭窄的准确性。结果:40层螺旋CT所显示的786支冠状动脉中狭窄61处,确诊52处、漏诊3处和误诊9处;敏感性94.5%,特异性98.7%;阳性预测值85.2%和阴性预测值99.5%。结论:40层螺旋CT对冠状动脉狭窄诊断有较高的准确性,可作为诊断冠状动脉狭窄的一种筛选手段。

Purpose： To evaluate the accuracy and feasibility of 40-muhislice spiral computed tomography （MSCT） in detecting coronary artery stenoses. Materials and Methods： 78 patients with suspected coronary artery disease underwent coronary angiography and 40-slice CT（SOMATOM SENSATION 40 CT ,Siemens, Germany）. The mean time span between coronary angiography （DSCA） and CTA was 21 days. Evaluation of right coronary artery （RCA）, left main （LM）, left anterior descending artery （LAD）, diagonal branch 1 （D1）, circumflex branch （CX）, and 1st marginal branch was performed by two. Invasive coronary angiography was taken as gold standard for calcula- tions of diagnostic accuracy. Results： 40 -slice spiralCT demonstrated in 786 coronary arteries narrow 61, diagnoses 52, to leak examines 3 and misdiagnoses 9 ;the sensitivity of CTA to diagnose significant stenosis was 94.5% , specificity 98.7% , positive predictive value （PPV） 85.2% and negative predictive value （NPV） 99.5%. Conclusion： 40 MSCT has a high accuracy for the detection of significant coronary artery stenoses and therefore can be used as a noninvasive screeningmethod in the diagnosis of coronary artery stenosis.