钙化对冠脉疾病64层螺旋CT诊断的影响研究

The influence of calcification on 64-slice spiral CT in diagnosing coronary artery disease

目的:评价64层螺旋CT(64SCT)在冠心病诊断中的应用价值及钙化积分对其检测的影响。方法:对72例疑似或确诊的冠心病患者进行64层螺旋CT检查,同期行选择性冠状动脉造影(ICA)。对两种方法评价冠状动脉结果进行对照研究。结果:72例冠状动脉造影可评估率为97.3%。与ICA对照分析,评价冠状动脉狭窄的敏感性、特异性、准确率、阳性预测值、阴性预测值分别为97.77%,93.74%,94.85%,85.60%和99.10%。钙化积分按节段分组低至高分组,敏感性分别为98.99%,98.61%,94.44%;特异性为95.51%,93.66%,90.78%。结论:64层螺旋CT成像可作为无创检查诊断的可靠方法,钙化积分越高则诊断的敏感性及特异性越低。

Objective：To evaluate the accuracy and feasibility of 64-slice spiral CT（64SCT） in diagnosis of coro- nary artery disease and the influnenee of calcification on it. Methods ：Seventy-two consecutive patients with suspected coronary artery disease underwent both 64-slice CT and invasivecoronary arteriongraphy（ICA）. The results of coro- nary reconstructions were compared with eorononary artery angiography to analyze the diagonostic accuracy of the 64SCT. Results ：In the 72 patients, 97.3 % were judged to he evaluated Dy 64SCT. Compare to the results of ICA ,the sensitivity, specificity, accuracy rate, positive predictive value, negative predictive value in detecting coronary artery stenoses were 97. 77%,93. 74%,94.85%,85.60% and 99. 10%. On a per-segment basis,From group low to high, sensitivity was 98.99% ,98.61% ,94.44% ,and specificity was 95.51% ,93.66% ,90.78% ,respectively. Conclusion： 64-slice CT is easy to perform,with a high degree of accuracy. Progressively higher coronary calcium levels affect diagnostic accuracy of CT coronary angiography,decreasing sensitivity and specificity on a per-segment base.