冠状动脉狭窄的多层螺旋CT诊断

Multidetector-row spiral CT for detection of coronary artery stenosis

目的 旨在评价多层螺旋CT(MDCT)诊断冠状动脉 (简称冠脉 )狭窄的可行性和准确性。方法 6 5名患者行冠脉MDCT造影 (MDCTA) ,扫描数据在回顾性心电门控下重建。有 32例同时接受选择性冠脉造影 (SCA)。分析CT图像质量 ,并与SCA比较 ,评价MDCTA诊断 5 0 %以上狭窄的准确性。结果 心率 70次 /min以下患者CT图像质量明显优于心率 70次 /min以上组 (W =5 39,P <0 0 0 0 1)。 32例MDCTA图像与相应SCA比较 ,MDCTA诊断 5 0 %以上狭窄的敏感度、特异度、阴性预测值和准确度分别为 95 %、80 %、89%和 90 %。结论 MDCT对冠脉能够高质量成像并可较准确诊断冠脉狭窄。

Objective To evaluate the feasibility and accuracy of multidetector row spiral CT (MDCT) in the detection of coronary artery stenosis. Methods Sixty five consecutive patients with suspected coronary artery disease (CAD) underwent the retrospectively ECG gated MDCT angiography for visualization of coronary artery lumen changes, and 32 of them were also investigated with selective coronary angiography (SCA). The image quality of MDCTA was analyzed. Presence and percentage of stenosis in coronary artery segments were determined. Results of determination of > 50% stenosis of the vessel diameter with MDCTA were compared to the findings of SCA. Results With MDCT angiography significant better image quality was achieved in patients with a heart rate below 70 beats per minute ( W =539, P <0.000 1). When compared with SCA, the sensitivity, specificity, negative predictive value, and accuracy for the detection of > 50% stenosis with MDCTA were 95%, 80%, 89%, and 90%, respectively. Conclusion Even if its effective exposure time of 250 ms is limited by faster heart rates, MDCT is capable of achieving high image quality and high accuracy for detection of coronary artery stenosis.