双源CT冠脉显像对老年患者冠脉疾病的诊断价值

The clinic application of dual source CT in the coronary angiography with old patients

目的探讨双源CT的冠脉成像技术对老年患者的诊断价值。方法对我院849例拟诊或确诊老年冠心病患者的心脏双源CT检查结果进行分析,评价双源CT对老年患者冠脉成像的特点及优势。结果双源CT能够清晰显示冠脉并发现冠脉连接/起源异常,对老年患者心肌桥血管的发现比例高达32.86%,并伴随相应节段冠脉异常比例达13.62%。与冠脉造影对比显示,双源CT对冠脉狭窄的阳性病变诊断的敏感度、特异度、阳性预测值、阴性预测值分别为71.43%、92.31%、71.43%、92.31%,准确度达到89.23%。结论双源CT能够较清晰地显示老年患者冠脉的起源和管腔狭窄情况,和金标准冠脉造影比较,显示出较高的准确度,可作为老年患者冠脉疾病了解的初筛手段。

Objective To explore the clinic value of the dual source computed tomography （DSCT）in old patients with coro- nary artery disease （CAD）. Methods A total of 849 consecutive patients with high probability of CAD underwent DSCT coronary an- giography. 38 patients of the recruited patients underwent selected coronary angiography at the same ＂time. Twe physicians indepengdent- ly assessed the images of all coronary segments. Results DSCT truely displayed the sources and structural variations of coronary arter- y. The diagnosis ratio of myocardial bridge in DACT was up to 32.86%. And 13.62% of the patients with myocardial bridge were foun- ded to have abnormality in the corresponding coronary. For the detection of stenosis of coronary on the per segment basis, DSCT showed a overall Sensitivity, specificity, positive predictive value, predictive value, accuracy ratio for evaluating CAD were 71.43% , 92.31% , 71.43 %, 92.31% , 89.23 % respectievely. Conclusions The DSCT has excellent sensitivity and specificity in detecting CAD, and also can give fairly accurate assessment of stenosis severity in most old patients as compared to CAG.