128层螺旋CT冠状动脉成像在冠心病诊断中的应用价值

Application value of 128-slices spiral CT coronary artery imaging in diagnosis of coronary heart disease

目的评价128层螺旋CT(128-SCT)冠状动脉成像在冠心病诊断中的应用价值。方法入选临床诊断为冠心病并行128-SCT冠脉成像检查的患者60例,在128-SCT检查后的4周内行冠状动脉造影(CAG)检查。以CAG检查结果为金标准,以冠状动脉节段为单位,对比分析各节段128-SCT及CAG检查结果,评估128-SCT诊断冠状动脉狭窄程度的准确性,同时计算128-SCT诊断冠心病的敏感性、特异性、阳性预测值、阴性预测值、诊断指数、诊断符合率及Kappa值等统计学指标。结果共评估60例患者的715个冠状动脉节段,对比CAG的结果,128-SCT有664个节段检查结果与CAG相符合,符合率达92.87%。128-SCT诊断冠心病的灵敏度为79.05%,特异度为98.52%,阳性预测值为90.22%,阴性预测值为96.47%,诊断符合率为95.66%,Kappa值为0.818。结论 128-SCT冠状动脉成像检出冠心病准确性较好,可作为诊断与排除冠心病的无创性检查方法。

Objective To review the application value of 128-slices spiral CT （128-SCT） coronary artery imaging in diagnosis of coronary heart disease （CHD）. Methods The patients （n=60） with diagnosed CHD and accepted 128-SCT coronary artery imaging were chosen, and given coronary angiography （CAG） after 128-SCT for 4 w . The results of CAG was taken as golden criterion and coronary section as unit, the results of 128-SCT and CAG were compared and analyzed. The veracity of 128-SCT in diagnosing coronary stenosis was reviewed, and sensibility, specificity, positive predictive value, negative predictive value, diagnosis index, diagnosis accordance rate and Kappa value were calculated. Results There were totally 715 coronary sections reviewed in 60 patients. The results of CAG comparison showed that 664 section examination results of 128-SCT were accorded with CAG outcomes （92.87%）. The sensibility of 128-SCT for diagnosing CHD was 79.05%, specificity, 98.52%, positive predictive value, 90.22%, negative predictive value, 96.47%, diagnosis accordance rate, 95.66%, and Kappa value, 0.818. Conclusion The veracity of 128-SCT for diagnosing CHD is higher, which can be used as a noninvasive method for diagnosing and excluding CHD in clinic.