双源CT诊断冠脉狭窄的价值—与冠状动脉造影对照分析

A comparative study of coronary artery imaging with dual source CT and coronary angiography in the diagnosis of coronary stenoses

目的:探讨双源CT冠脉成像评价冠脉中度及中度以上狭窄的准确性及可行性。方法:入选60例临床高度怀疑或已确诊冠脉疾病的患者,行双源CT扫描,扫描过程中患者心率平稳,未出现心率不齐及心律失常。患者于1周内行经皮选择性冠状动脉造影,并以冠状动脉造影作为标准,从冠脉节段及冠脉分支角度分别评价双源CT诊断冠脉中度及中度以上狭窄的准确性、敏感性、特异性、阳性预测率及阴性预测率。结果:以冠脉节段为基础分析,双源CT诊断冠脉明显狭窄的敏感性、特异性、阳性预测率、阴性预测率、准确性分别为81.14%、97.57%、85.34%、96.74%、95.13%;以冠脉分支为基础分析,双源CT诊断冠脉明显狭窄的敏感性、特异性、阳性预测率、阴性预测率、准确性分别为84.21%、93.79%、89.88%、90.06%、90.0%。双源CT与选择性冠脉造影对发现冠脉狭窄节段及检查冠脉分支病变的能力进行卡方检验,χ2分别0.625、1.041;P>0.05,双源CT与选择性冠脉造影比较在发现冠脉明显狭窄差异上无统计学意义。结论:双源CT在诊断冠脉明显狭窄时有很高的准确性,可作为无创性评价冠脉狭窄及疾病的手段。

Objective：To evaluate the accuracy and feasibility of dual-source CT in detecting coronary artery stenoses.Methods：DSCT angiography was performed on 60 patients with suspected or proven coronary heart diseases and coronary angiography（CAG） in these patients with one week.The CAG results were served as ＂gold standard＂ to evaluate the diagnostic accuracy of DSCT in coronary artery significant stenosis in per-segment and in per-artery analysis.Results：In per-segment analysis.The sensitivity,specificity,positive predictive value,negative predictive value and agreement rate of DSCT were 81.14%,97.57%,85.34%,96.74%,95.13%;In per-artery analysis.The sensitivity,specificity,positive predictive value,negative predictive value and agreement rate of DSCT were 84.21%,93.79%,89.88%,90.06%,90.0%.There was no statistical difference in the diagnosis of coronary artery stenosis between DSCT and CAG（P0.5）.Conclusion：Dual-source CT has a high accuracy in diagnosis of coronary artery stenoses and can be regard as one of non-trauma method to diagnosis coronary artery stenoses.