双源CT评价冠状动脉不同狭窄程度68例分析

Dual-source CT angiography analysis of different stenosis degree of coronary artery in 68 cases

目的:探讨双源CT冠状动脉(冠脉)成像(DSCTCA)对冠脉不同狭窄程度的诊断价值。方法:回顾性分析68例在我院先后接受DSCTCA和冠脉造影(CAG)检查的患者,应用双盲法对其DSCTCA与CAG图像资料进行对比分析。结果:68例患者均获得了良好的冠脉影像。DSCTCA显示970(99.28%)节段可用于评估,与CAG对照,共有899(92.68%)节段诊断结果一致。DSCTCA与CAG两组间配对χ2检验结果:①中重度狭窄分别为206段(21.2%,206/970)与200段(20.6%,200/970)(P>0.05),其中178段(19.8%,178/899)结果一致;②轻度狭窄分别为179段(18.5%,179/970)与156段(16.1%,156/970)(P<0.05),其中142段(15.8%,142/899)结果一致。Kappa检验表明,DSCTCA对冠脉不同狭窄程度的诊断与CAG的一致性较高。结论:作为一种无创性检查,DSCTCA不仅可以用于冠脉中重度狭窄的冠心病患者介入治疗的术前检查与临床随访复查,而且可以作为冠脉轻度狭窄患者的无创性筛查与随访观察。

Objective：To discuss the diagnostic value of dual-source CT coronary angiography （DSCTCA） in evaluating the coronary artery stenosis degree. Method：Sixty-eight patients who were examined by DSCTCA and coronary angiography （CAG） were retrospectively reviewed respectively. Then the images data of DSCTCA and CAG were compared and analyzed by double-blind. Result： Allpatients had high-quality coronary artery image. Total 970 （99.28%） segments of coronary artery on DSCTCA could be evaluated, and 899 （92.68%） segments were diagnosed agreement with CAG. The results of the paired x2 test between DSCTCA and CAG showed： （1）The medium-high grade stenosis of coronary artery were 206 （21.2o//00, 206/970） segments and 200 （20.6%, 200/970） segments respectively, and the coincident diagnosis were 178 （19.8%, 178/899） segments （P）0.05）. （2）The mild grade stenosis of coronary artery were 179 （18.5%, 179/970） segments and 156 （16.1%, 156/970） seg- ments respectively, and the coincident diagnosis were 142 （15.8% 142/899）segments （P〈0. 001）. Kappa test results showed higher consistency of the diagnosis of coronary stenosis between DSCTCA and CAG. Conclusion.. As a noninvasive examination method, DSCTCA could be used not only for pre-operation evalution and follow-up review in coronary heart disease patients with medium-high grade stenosis of coronary artery, but also for screen- ing patients with mild grade stenosis of coronary artery.