多层螺旋CT冠状动脉成像在冠心病诊断中的价值

The Clinic Value of Multi-slice Spiral CT Coronary Angiography in the Diagnosis of Coronary Heart Disease

目的探讨多层螺旋CT冠状动脉造影（CTCA）诊断冠状动脉狭窄的准确性及应用价值。方法40例符合标准的患者分别行CTCA及选择性冠状动脉造影（SCA）检查，比较二者的一致性。结果CTCA对1—3级冠状动脉分支的显示较好。但对4级冠状动脉分支显示欠佳。CTCA显示管径〉12mm的冠状动脉，狭窄I〉50％的灵敏度为88．78％，特异度为96．05％；阳性预测值为82．86％，阴性预测值97．55％，假阳性率为17．14％，假阴性率为2．45％，准确率为92．96％。CTCA和SCA对冠状动脉狭窄的诊断一致性，差异无统计学意义（P=0．431）。结论CTCA是一种快速、无创和可靠的冠状动脉成像方法，与SCA诊断具有较高的一致性，可用于冠心病患者的常规筛查，但必要时仍需行SCA检查，为其临床诊治提供更为准确的信息。

Objective To discuss the accuracy and application value of multi-slice spiral CT coronary angiography （CT- CA） in the diagnosis of coronary stenosis. Methods 40 cases which were conforming to standards were using CTCA and selective coronary angiography（SCA） inspection, then consistency of the results were compared. Results CTCA well showed level 1 - 3 coronary artery branches, but poorly showed level 4 coronary artery branches. In coronary artery （diameter ≥ 2 mm, stenosis ≥ 50% ） the sensitivity and specificity of CTCA were 88. 78%, 96.05% ; The positive and negative predictive value were 82. 86% , 97. 55%, The false positive and negative rate were 17. 14%, 2. 45%, the precision was 92. 96%. The consistency of CTCA and SCA diagnosis had no significant difference （P = 0. 431 ）. Conclusion CTCA is a rapid, noninvasive, and reliable method for coronary artery imaging, which has high consistency with SCA diagnosis, can be used for routine screening in coronary heart dis- ease, but still need SCA inspection when necessary, to provide more accurate information for clinical diagnosis and treatment.