CT冠状动脉成像在冠心病诊断中的应用

CT coronary artery imaging for coronary artery disease

目的:研究CT冠状动脉成像在冠心病早期诊断冠状动脉狭窄定性定量判读的作用。方法:对34例临床未发生急性冠脉综合征的冠心病患者,先后进行冠状动脉造影、128排双源CT冠状动脉成像。以冠状动脉造影为"金标准",计算CT冠状动脉成像敏感性、特异性、阳性预测值、阴性预测值。结果:①与冠状动脉造影相比,CT冠状动脉成像的敏感性为68%,特异性为97%,阳性预测值为89%,阴性预测值为90%。②CT冠状动脉成像有65个血管段图像质量差,约占12%,造成图像质量差的原因主要为钙化,心跳、呼吸伪影,少部分为管腔显示不良。结论:冠心病早期诊断中,CT冠状动脉成像可用作冠状动脉造影前筛选,CT冠状动脉成像阴性的患者不必行冠状动脉造影检查;CT冠状动脉成像阳性的患者,可行冠状动脉造影进一步确认病变。

Objective：To study the role of CT coronary artery imaging in early diagnosis of coronary artery disease（CAD）,coronary arteriostenosis and identification of atherosclerotic plaque.Methods： A total of 34 CAD patients without clinical acute coronary syndrome received coronary angiography（CAG） and 128-detector row CT coronary artery imaging.The result of CT coronary artery imaging was compared with that of CAG as ＂the gold standard＂.The sensitivity,specificity,positive predictive value and negative predictive value of CT coronary artery imaging were calculated.Results：Compared with CAG,the sensitivity,specificity,positive and negative predictive value of CT coronary artery imaging were 68%,97%,89% and 90% respectively.The poor image quality was found in 65 artery sections（12%） on CT coronary artery imaging,which mainly resulted from calcification and constructed defect from palmus and breathing,and partly from poor display of vessel lumens.Conclusion： CT coronary artery imaging can be used as a screening tool for the early diagnosis of CAD before coronary angiography.The coronary angiography should be performed for patients with positive CT results and not for negative results.