双源CT对男性冠状动脉粥样硬化性心脏病的诊断价值

Value of Dual Source CT in diagnosis of coronary atherosclerotic heart disease in men

目的探讨双源CT(DSCT)对男性和女性冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease,CAHD)的诊断价值。方法入选疑诊为CAHD的受检者共105例(男61例,女44例),分别行DSCT和选择性冠状动脉造影(coronary angiography,CAG)检查,以CAG为诊断CAHD的金标准,评估检查结果。结果 105例受检者中,DSCT共显示1184个冠状动脉节段可进行评价。DSCT诊断男性受检者冠状动脉显著狭窄的敏感性为93.6%,特异性为95.1%,阳性预测值为73.9%,阴性预测值为99.0%,诊断符合率为94.9%;诊断女性受检者冠状动脉显著狭窄的敏感性为84.1%,特异性为94.4%,阳性预测值为77.9%,阴性预测值为96.2%,诊断符合率为92.4%。女性受检者接受DSCT检查诊断冠状动脉显著狭窄的敏感性和阴性预测值低于男性(P<0.05)。结论 DSCT在显示冠状动脉病变时具有较高的诊断准确率,尤其适用于男性。

Objective To discuss the value of Dual Resource CT（DSCT） in diagnosis of coronary atherosclerotic heart diseases（CAHD）. Methods Both DSCT and selective coronary angiography（CAG） were performed in 105 patients（61 males,44 females）. Results were compared with CAG findings which were regarded as gold standard for detecting CAHD.Results 1184 coronary artery segments could be evaluated by DSCT in all the 105 patients.The sensitivity,specificity,positive predictive value,negative predictive value and diagnose accordance rate of DSCT in detecting significant coronary stenosis were 93.6%,95.1%,73.9%,99.0%,and 94.9% in males,while in females were 84.1%,94.4%,77.9%,96.2%,and 92.4%.The analysis demonstrated lower sensitivity and negative predictive value in females compared with those in males（P 0.05）. Conclusions DSCT is a high accurate method in detecting CAHD,which may be preferable for males.