双源CT冠状动脉成像与冠状动脉造影的对比研究

A comparative study between dual-source CT coronary angiography and coronary angiography

目的探讨双源CT冠状动脉成像(DSCTCA)对冠状动脉斑块的诊断价值。方法选取50例疑诊冠心病患者,使用双源CT进行冠状动脉成像,并于3周内行冠状动脉造影(CAG)。与CAG的结果进行对比,了解DSCTCA对于冠状动脉斑块的种类、大小、慢性完全闭塞病变(CTO)以及解剖学分布的诊断价值。结果 50例患者中,DSCTCA显示的冠状动脉直径≥1.5 mm节段有580个,571个节段可进行评估,共检测出129个粥样硬化斑块,检出率为23%,其中69%为大斑块,28%为小斑块,70%为钙化斑块,CTO病变共检出4个,心肌桥(MB)5个,与CAG相比,DSCTCA诊断冠状动脉斑块的敏感性、特异性、阳性预测值、阴性预测值分别为98.3%、97.3%、92.2%、99.1%。结论 DSCTCA能评价冠状动脉狭窄程度,对钙化病变、CTO病变、MB的诊断具有较高的准确性和敏感性,可作为高危人群冠心病筛查的首选方法。

Objective To investigate the value of dual-source CT coronary angiography（DSCTCA） in diagnosis of coronary plaque.Methods The total 50 patients of suspected coronary artery diseases had undergone DSCTCA and coronary artery angiography（CAG） in three weeks.Compared with CAG,the cononary plaques were evaluated including types,size,chronic total occlusion（CTO） and its anatomic distribution.Results In the 580 segments of coronary artery（diameter≥1.5 mm） of 50 patients,571 were evaluated by DSCTCA.The total 129 plaques were detected,which was about 23% of all segments,Plaque was large in 69% of segments and small in 28%.70% of plaque were calcified.CTO were detected in 4 patients,myocardial-bridge（MB） in 5 patients.Compared with CAG,the sensitivity,specificity,positive predictive value and negative predictive value of the DSCTCA in detecting coronary artery diseases were 98.3%,97.3%,92.2%,99.1% respectively.Conclusion DSCTCA can assess coronary artery stenosis degree,which provides high accuracy and sensitivity on calcification lesions,CTO and MB.It is a useful non-invasive method in diagnosis of coronary heart diseases.