64排螺旋CT冠状动脉成像在冠心病诊断中的价值

评估螺旋CT冠状动脉成像的图像质量和诊断准确性。方法对52例接受64层螺旋CT冠状动脉成像并作选择性冠状动脉造影（SCAG）患者，通过主观评分方式评估其64-SCTCA的图像质量，同时通过比较64-SCTCA和SCAG的一致性，评估64-SCTCA的诊断准确性。结果64-SCTCA的图像质量均良好，平均（3．44± 0．94）分，主干及近端分支成像清晰，远端基本满意；对冠心病诊断的灵敏度96．8％，特异性95．5％，阳性预测值96．3％，阴性预测值95．2％；对冠状动脉中等度以上狭窄准确性高，对轻度狭窄准确性相对较差。结论64层螺旋CT冠状动脉成像具有良好的图像质量和诊断准确性，有较高的临床应用价值。

Objective To investigate the image quality and the diagnostic accuracy of the 64 - slice spiral CT coronary angiography. Methods Fifty two patients who underwent 64 - SCTCA and selective coronary arteriograph （SCAG） from Jan. 2009 to Aug. 2011 in our hospital were covered in this study. The image quality was evaluated by subjective scoring. And the diagnostic results by 64 - SCTCA were compared with the results by SCAG to evaluate its diagnostic accuracy. Results The image quality of 64 - SCTCA was observed preferable （ an average score of 3.4 ± 0. 94） with a. clear display of the main coronary arteries and their proximal branches, and with a satisfactory imaging of the distal branches. The evaluation of the diagnostic accuracy of 64 - SCTCA found a 96. 8% sensitivity, a 95.5% specificity, a 96. 3% positive predictive value and a 95.2% negative predictive value. In addition, the 64 - SCTCA was with a favorable diagnostic accuracy for detect coronary stenosis beyond moderate degree while its accurary for diagnose mild coronary stenosis was relative poor. Conclusion A preferable image quality and diagnostic accuracy of 64 - SCTCA suggest its potency of clinical usefulness.