双源CT低管电压冠状动脉成像对冠状动脉狭窄的诊断

Diagnosis of Coronary Luminal Stenosis in Dual-source CT Coronary Angiography Using Low-tube-voltage

目的:与常规冠状动脉造影(CAG)作对照,探讨低管电压CT冠状动脉成像(CTCA)诊断冠状动脉狭窄的价值。方法:52例疑似冠状动脉疾病的患者行双源CTCA及CAG检查,将CTCA与CAG诊断结果进行对照。评价两种检查方法对冠状动脉狭窄诊断的一致性,并评估双源CTCA诊断冠状动脉明显狭窄(≥50%)的敏感性、特异性、阳性预测值、阴性预测值及诊断准确性。结果:CTCA与CAG诊断冠状动脉狭窄的一致性好(kappa值=0.839)。以冠状动脉分支为单位时,CTCA诊断冠状动脉明显狭窄的敏感性、特异性、阳性预测值、阴性预测值及诊断准确性分别为97.2%、95.2%、89.1%、97.6%和96.2%;以冠状动脉节段为单位时,相应的值分别为98.1%、96.3%、92.7%、99.0%和96.8%。结论:低管电压双源CTCA诊断冠状动脉狭窄临床价值高,值得应用推广。

Objective： To evaluate value of low-tube-voltage dual-source computed tomographic coronary angiography （CTCA） for diagnosis of coronary luminal stenosis in comparison with conventional coronary angiography （CAG）. Methods： 52 patients who suspected for coronary disease underwent dual-source CTCA and CAG examinations. The agreement between the CTCA and CAG in assessing the coronary luminal stenosis was assessed. Sensitivity, specificity, positive predictive value （PPV）, negative predictive value （NPV） and accuracy for significant stenosis in CTCA （〉50%） were also assessed. Result： The agreement between the CTCA and CAG in assessing coronary luminal stenosis was good （kappa value = 0.839）. The sensitivity, specificity, PPV, NPV and accuracy for significant coronary luminal stenosis based on coronary branch were 97.2%, 95.2%, 89.1%, 97.6% and 96.2%, respectively, and the sensitivity, specificity, PPV, NPV and accuracy for significant coronary luminal stenosis based on coronary segment were 98.1%, 96.3%, 92.7%, 99.0% and 96.8%, respectively. Conclusion： There is a good value in diagnosis of coronary luminal stenosis in CTCA with low-tube-voltage setting, which is worth to application and generalization.