64层螺旋CT在冠心病诊断中的价值

Diagnostic significance of contrast-enhanced electron 64 bed spiral computed tomograph and coronary angiography in the diagnosis of coronary artery stenosis

目的评价64层螺旋CT增强扫描对冠状动脉狭窄的诊断意义。方法156例患者分别行64层螺旋CT增强扫描和经皮冠状动脉血管造影术(CAG),由两位不知造影结果的医师进行阅片,并以CAG结果作为标准进行对比分析。结果64层螺旋CT判断近段血管狭窄(管腔狭窄≥50%)的灵敏度是:左主干(LM)99%,右冠状动脉(RCA)93%,左前降支(LAD)89%,左回旋支(LCX)82%,判断远段血管狭窄的灵敏度为:RCA56%,LAD45%,LCX43%(P<0.05)。结论64层螺旋CT增强扫描及其三维重建与冠状动脉血管造影结果具有高度的相关性,通过经静脉增强造影,64层螺旋CT可以清楚显示冠状动脉并判断管腔的狭窄,尤其是近段的重度狭窄。

Objective To evaluate the application the diagnostic significance of 64 bed spiral computed tomograph for coronary artery stenosis. Methods Coronary angiography and intravenous contrast material enhanced electrocardiographically triggered 64 bed spiral computed tomograph were performed for 156 patieents. The coronary arteries were assessed by two doctors who did not know the result of angiography. Results The sensitivitiees of 64 bed spiral computed tomograph identify proximal stenosed arteries （ luminal stenosis ≥50% ） wer 99% in left main （LM） coronary arteies, 93% in right coronary arteries（RCA） , and 89% in left anterior （LAD）descending arteries and 82% in left circumflex arteries（LCX） . The sensitivities of 64 bed spiral computed tomograph identifying distal stenosed arteries were 56% in right coronary arteries, 45% in left anterior descending arteries and 43% in left circure flex arteries （ P 〈 0.05 ）. Conclusion 64 bed spiral computed tomograph results are closely correlated with those of coronary angiography. By using intravenous contrast enhancement, 64 bed spiral computed tomograph could show clearly the coronary artery and judge the lumen stenosis, especially the severe stenoses in proximal.