摘要
目的:探讨64层螺旋CT(MSCT)冠状动脉成像对冠状动脉狭窄的诊断价值。方法:53例冠心病患者同期均行64层螺旋CT冠状动脉成像和常规冠状动脉造影(CCA),以CCA的诊断结果作为金标准,采用美国心脏协会冠状动脉改良分段法,分析745个冠状动脉节段MSCT图像质量及对冠状动脉狭窄的显示情况,得出有意义病变(冠状动脉狭窄率≥50%)MSCT诊断的正确性,并分析钙化对其影响。结果:587个冠状动脉节段图像可以满足诊断要求,158个节段因运动伪影(27个节段)或管壁严重钙化(131个节段)无法进行血管评价。MSCT诊断冠状动脉狭窄的敏感度为93.4%、特异度为97.9%、阳性预测值为93.9%、阴性预测值为97.7%。钙化积分≥1000的患者,MSCT诊断冠状动脉狭窄的特异度、敏感度、阳性预测值、阴性预测值分别为74%、82%、68%、96%。结论:64层螺旋CT冠状动脉成像是一种快速、安全、无创的检查方法,与常规冠状动脉造影检查结果有较好的一致性,可以作为临床怀疑冠心病患者的首选检查方法。
Objective：To study the diagnostic value of 64-slice spiral CT coronary angiography in coronary artery stenoses. Methods：Fifty-three patients underwent both 64 slice spiral coronary angiography and conventional coronary angiography （CCA）. Conventional coronary angiography was taken as golden standard,using a 15 segment modified AHA classi fication,to evaluate the image quality of 745 available coronary segments of MSCT and the performance in detecting coro nary artery lesions, to obtain the diagnostic accuracy of MSCT of significant lesions （a lumen restriction of ≥50%）,and to analyze the impacts of coronary artery calcium on the diagnostic accuracy. Results： There were 587 coronary segments considered to have diagnostic image quality, but 158 segments could not be evaluated for motion artifacts （27 segments） and severe calcifications （131 segments）. The sensitivity, specificity, positive predictive value and negative predictive value of MSCT in detecting lesions were 93.4 %, 97. 9 %, 93.9 % and 97.7 %, respectively. When calciulm score was ≥ 1000, the sensitivity, specificity, positive predictive value and negative predictive value were 74 %, 82 %,68 %, 96 %, respectively. Conclusion：64-slice spiral CT coronary angiography is a fast, safe and noninvasive examination method,it has a fairly good identity with CCA in detecting coronary artery stenosis and should be the first choice of method for detecting suspected pa tients.
出处
《放射学实践》
北大核心
2009年第4期396-399,共4页
Radiologic Practice
