256层螺旋CT冠脉成像诊断冠脉狭窄的价值

The Diagnostic Value of 256-slice CT Angiography for Coronary Artery Stenosis

目的评价256层螺旋CT冠状动脉成像(CTA)在诊断冠状动脉狭窄中的应用价值。材料与方法 142例拟诊冠心病患者进行256层CTA和X线冠状动脉造影(CAG)检查,计算诊断的灵敏度、特异度、阳性预测值及阴性预测值,以Kappa检验分析二者诊断冠脉狭窄的一致性。结果 1、CTA诊断左前降支、回旋支及右冠脉狭窄的灵敏度分别为97.66%,100%和100%,特异度为92.86%,90.91%和91.67%,阳性预测值为99.20%,92.86%,93.75%,阴性预测值为81.25%,100%和100%,一致性Kappa值分别为0.851、0.915、0.924;2、CTA显示冠状动脉狭窄分级的Kappa值为0.786;3、CTA显示冠状动脉狭窄部位的Kappa值为0.520。结论 256层CTA判断冠状动脉是否狭窄、狭窄程度及部位均与CAG有较好的一致性,在诊断冠状动脉狭窄中具有较好的应用价值。

Objective To evaluate the application valt, e of 256-slice CT Angiography （CTA） for the diagnosis of coronary artery stenosis. Materials＂ and Methods＂ 142 patients which were preliminarily diagnosed as coronary artery disease we,＇e examined by 256-slice CTA and CAG. The sensibility, specificity, positive predictive value and negative predictive value were calculated, and the concordence of these two methods were analyzed by Kappa test. Results 1. The sensitivity of CTA to diagnose stenosis of left anterior descending branch, left circumflex branch and right coronary artery was 97.66%, 100% and 100% respectively, and the specificity was 92.86%. 90.91% and 91.67%. The positive predictive value was 99.20%, 92.86%. 93.75%, and the negative predictive value was 81.25%.100% and 100%. The Kappa value was 0.851,0.915, 0.924 respectively.2. CTA could show the classification of the coronary artery stenosis （Kappa=0.786）.3. CTA could show the location of the coronary artery stenosis （Kappa=0.520）. Conclusion 256-slice CTA has a good concordence with show similar diagnostic veracity in evaluating the classification and location of the coronary artery stenosis, except for slightly different in various branch of coronary artery. CTA could be a potential alternative to CAG for evaluating coronary artery stenosis.