应用320排CT评价冠状动脉狭窄的临床研究

Clinical Study of Coronary Artery Stenosis by Using 320-slice CT

目的:通过与冠状动脉造影(CAG)相比较,评价320排动态容积CT冠状动脉成像在诊断冠状动脉狭窄方面的准确性。方法:选择冠心病诊断明确或可疑冠心病患者共60例(男38例,女22例)。所有患者的心律均为窦性心律,心率≥70次/min的患者口服美托洛尔控制心率;均同期行320排动态容积CT(DVCT)与冠状动脉造影,将两种结果进行对照研究。结果:320排动态容积CT显示的780个冠状动脉节段中(每位患者分为13个节段),均符合影像学评价要求;与冠状动脉造影相比较,320排动态容积CT发现冠状动脉狭窄的总体敏感性为92.9%,特异性97.3%,阳性预测值91.9%,阴性预测值97.7%;对于冠状动脉狭窄检出的准确率为96.2%。结论:320排动态容积CT能够较为准确的诊断冠状动脉狭窄程度,可作为一种简便、易行的无创性诊断冠心病的有效方法。

Purpose： To evaluate the accuracy of 320-slice dynamic volume CT in diagnosis of coronary artery stenosis by comparing the result of them with coronary angiography （CAG）. Methods： 320-slice dynamic volume CT and coronary angiography were performed in 60 patients （38 male, 22 female） who were with known or suspected coronary artery diseases（CAD）. The heart rhythm of all the patients was stable sinus. Patients with initial heart rate /〉70 bpm received iS-blockers. The stenosis degree of the coronary arteries was evaluated on the 320-slice dynamic volume CT and CAG. Results： In 780 coronary artery segments （13 coronary segments for each patient）, none of them need to be excluded from analysis. CAG was used as the golden standard, overall sensitivity, specificity, positive predictive value and negative predictive value of 320-slice dynamic volume CT for classifying stenosis was 92.9%, 97.3%, 91.9%, and 97.7%, respectively. The accurate rate of 320-slice dynamic volume CT in detecting coronary artery stenosis was 96.2%. Conclusion： 320-slice dynamic volume CT had high sensitivity and negative predictive value for detection of coronary significant stenosis, and can be used as a potential, noninvasive examination method for diagnosing or excluding coronary heart disease in patients.