256层螺旋CT诊断冠状动脉管腔狭窄的价值

Diagnostic Value of 256-slice Spiral CT for Coronary Artery Luminal Stenosis with

目的研究256层螺旋CT冠状动脉成像(256MSCTCA)诊断冠状动脉管腔狭窄的准确性,评价256MSCTCA和选择性冠状动脉造影(SCA)诊断冠状动脉管腔狭窄的一致性。方法回顾性分析2013年2月至2013年3月在河北联合大学附属医院1个月内同时进行256MSCTCA检查及SCA检查的39例临床疑似冠心病或确诊为冠心病的患者,并将结果进行对照分析。结果以SCA检查结果为金标准,256MSCT诊断冠状动脉管腔狭窄程度≥50%及管腔狭窄程度≥75%的准确度、灵敏度、特异度、阳性预测值、阴性预测值、假阳性率及假阴性率分别为96.39%、88.24%、97.53%、83.33%、98.34%、2.47%、11.76%和97.83%、92.11%、98.26%、79.55%、99.41%、1.74%、7.89%。256MSCT及SCA两种检查方法诊断冠状动脉管腔中、重狭窄差异无统计学意义(P>0.05),并且具有良好的一致性,Kappa值为0.837、0.842。结论 256MSCTCA对冠状动脉管腔狭窄的诊断有很高的准确性,阴性预测值较高,256MSCT应作为冠心病及冠状动脉病变筛查的首选方法。

Objective To study the accuracy of 256-slice spiral CT coronary imaging diagnosis （256MSCTCA） for coronary stenosis and evaluate the consistency of 256-slice spiral CT coronary imaging and selective coronary angiography（SCA） in the diagnosis of coronary artery stenosis.Methods A total of 39 cases of clinically suspected coronary heart disease or diagnosed coronary heart disease patients from Hebei United University Affiliated Hospital was given both 256MSCTCA and SCA during Feb.2013 and Mar.2013,and the results were compared.Results SCA inspection results as the gold standard,the accuracy,sensitivity,specificity,positive predictive value,negative predictive value,false positive rate and false negative rate of 256MSCT diagnostic coronary luminal stenosis ≥50％ and lumen stenosis ≥75％ were 96.39％,88.24％,97.53％,83.33％,98.34％,2.47％,11.76％ and 97.83％,92.11％,98.26％,79.55％,99.41％,1.74％,7.89％,respectively.256MSCT and SCA had no significant difference in the diagnosis of medium and heavy degree coronary artery stenosis（P ＞ 0.05）,and the consistency was good with Kappa values of 0.837,0.842.Conclusion 256MSCT coronary angiography has high accuracy in the diagnosis of coronary artery luminal stenosis,with high negative predictive value,and 256MSCT should be used as the preferred method of screening for coronary heart disease and coronary artery lesions.