双源CT成像评价冠状动脉病变的临床价值

Clinical value of dual-source CT in evaluating coronary artery disease

目的通过双源CT对冠脉检查与选择性冠状动脉造影的对比分析,探讨DSCT对冠脉病变诊断的意义。方法 55例同期行双源CT冠状动脉血管成像及选择性冠状动脉血管造影(CAG)检查的患者,分析比较DSCTCA的敏感性、特异性及准确度。结果 (1)DSCT冠状动脉造影按病例计算,诊断冠心病的敏感度、特异度、阳性和阴性预测值、准确度分别为97.7%、72.6%、93.5%、88.9%和92.7%;按病变血管计算,其敏感度、特异度、阳性和阴性预测值、准确度分别为94.9%、95.8%、92.5%、97.1%、95.5%;按可评价节段计算,检测节段病变总的敏感度、特异度、阳性和阴性预测值、准确度分别为88.2%、96.9%、90.5%、96.1%、94.7%。(2)DSCT造影与选择性冠脉造影比较对冠心病的诊断的差别无统计学意义;对诊断各支血管的敏感度、特异度、阳性和阴性预测值、准确度的差别无统计学意义。结论双源CT对冠心病的诊断准确度接近选择性冠状动脉造影,在冠状动脉疾病的筛查方面,DSCTA在一定程度上可替代CAG。

Objective To analyze the clinical value of dual-source CT（DSCT） in the diagnosis of coronary artery disease.Methods Fifty-five patients with suspected coronary heart disease underwent both DSCT coronary angiography（DSCTCA） and selective coronary angiography（CAG） examination,and the diagnostic sensitivity,specificity and accuracy of the DSCTCA was evaluated.Results The sensitivity,specificity,positive and negative predictive value,and accuracy of DSCT in the diagnosis of coronary heart disease were 97.7%,72.6%,93.5%,88.9%and 92.7%by the numberof patients,respectively;by calculating the coronary arteries,the sensitivity,specificity,positive and negative predictive value,accuracy were 94.9%,95.8%,92.5%,97.1%,95.5%,respectively.According to the lesion segment,these values were 88.2%,96.9%,90.5%,96.1%,94.7%,respectively.DSCTCA showed no significant difference from CAG for a diagnostic purpose,nor did their vessel sensitivity,specificity,positive and negative predictive value,and accuracy in different coronaries differ significantly.Conclusion DSCT has a diagnostic accuracy of coronary heart disease close to that CAG and can on some occasion serve as an alternative to CAG in the screening of coronary artery disease.