16层螺旋CT冠状动脉成像的临床研究

Clinical reseanch of sixteen-slice row spiral CT coronary artery imaging

目的探讨16层螺旋CT冠状动脉成像方法及评估其临床应用价值。方法应用西门子SOMATOM16层螺旋CT对21例可疑或已诊断冠心病人进行扫描,获取相关数据,应用后处理工作站对其进行容积再现图像(VRT)、最大密度投影(M IP)、曲面重建(CPR)、平面重组(MPR)成像,分析冠状动脉狭窄程度及狭窄原因,再与该21例病人的CAG结果进行对比。结果16层螺旋CT判断冠状动脉轻度、中度及高度狭窄的敏感度,特异度,阳性预测值,阴性预测值分别为84.6%、40.0%、55.0%、75.0%、88.2%、69.6%、72.7%、88.9%、90.0%、87.5%、78.3%、94.6%;未钙化斑块致冠脉中高度狭窄程度结果与CAG评价结果一致性为94.7%;而钙化斑块对冠状动脉狭窄程度评价有一定局限性。结论16层螺旋CT冠状动脉成像用于可疑冠心病筛查及冠心病的诊断有很高的临床价值。且相对CAG检查是一种无创安全可靠价廉的检查方法,适合推广。

Objective To discuss the method of sixteen - slice row spiral CT coronary artery imaging and to evaluate its clinical significance. Methods Twenty one patients with suspected or diagnosed coronary heart disease have undergone sixteen - slice spiral CT scanning（ Somatom） for acquiring correlated data, and VRT, MIP, CPR and MPR imaging were carried out through the working station, then the stenosis of coronary artery was quantitatively assessed. The reasons and degree of coronary artery stenosis were studied and their findings were compared with resuits of CAG of these 21 patients. Results The sensitivity, specificity and positive predictive value of sixteen - slice spiral CT scanning in diagno- sing low - grade, moderate and severe coronary stenosis and they were 84.6%, 40.0%, 55.0%, 75.0%, 88.2%, 69.6%, 72.7%, 88.9%, 90.0%, 87.5%, 78.3% and 94.6% respectively. The consistency of results of moderate and severe coronary stenosis with non - calcified spot mass in comparison with results of CAG was 94.7%. However its evaluation in extent of coronary artery stenosis with calcified spot mass was limited. Conclusion Sixteen - slice row spiral CT coronary artery imaging has clinical significance in screening suspected coronary heart disease and in diagnosis of coronary heart disease. It is a non - invasive, safe and low cost method in comparison with CAG.