64层螺旋CT在冠状动脉搭桥术后的诊断价值

Clinical values of 64-slice spiral computed tomography in diagnosis after coronary artery bypass grafting

目的评价64层螺旋CT(64-slice spiral computed tomography,64SCT)在冠状动脉搭桥术(coronary artery bypass grafting,CABG)后的诊断价值。方法选用19例冠状动脉搭桥术后的患者,使用64层螺旋CT对其桥血管及自体冠状动脉狭窄进行评价,以冠状动脉造影(coronary angiography,CAG)作为金标准计算64层螺旋CT诊断冠状动脉桥血管及自体冠状动脉狭窄的敏感性、特异性、阳性预测值、阴性预测值。结果64层螺旋CT诊断桥血管狭窄的敏感性为100%,特异性为94%,阳性预测值为88%,阴性预测值为100%;64层螺旋CT诊断桥血管狭窄与冠状动脉造影相比在统计学上差异无显著性。64层螺旋CT诊断自体冠状动脉狭窄的敏感性为90%,特异性为83%,阳性预测值为63%,阴性预测值为96%;结论64层螺旋CT诊断桥血管及自体冠状动脉狭窄有较高的敏感性、特异性、阳性预测值、阴性预测值,可作为冠状动脉搭桥术后诊断桥血管及自体冠状动脉狭窄常规的无创方法。

[ Objective ] To evaluate the clinical values of 64-slice spiral computed tomography （64SCT） in diag nosis after coronary artery bypass grafting （CABG）. [Methods] A total of 19 patients after CABG had been examined by both 64SCT and coronary angiography （CAG）. To calculate the sensitivity, specificity, positive predict value and negative predict value of 64SCT in diagnosis of stenosis of bypass grafts and native coronary arteries, comparing with CAG regarded as the golden standard. [ Results ] The sensitivity, specificity, positive predict value and negative predict va.lue of 64SCT werel00%, 94%, 88% and 100%respectively for the diagnosis of stenosis of bypass grafts. There are not differences between 64SCT and CAG in statistics. The sensitivity, specificity, positive predict value and negative predict value of 64SCT were 90%, 83%, 63% and 96% respectively for the diagnosis of stenosis of native coronary arteries. [ Conclusion] 64SCT has excellent sensitivity, specificity, positive predict value and negative predict value in diagnosis of stenosis of bypass grafts and native coronary arteries. It is a feasible as a routine and noninvasive method to diagnose stenosis of bypass grafts and native coronary arteries after CABG.