CT冠状动脉成像与冠状动脉造影诊断冠心病对照研究

Diagnosis of Coronary Heart Disease: CT Coronary Angiography Versus Coronary Angiography

目的探讨64层螺旋CT冠状动脉成像与冠心病的共性及差异,为临床诊断提供依据。资料与方法 49例拟诊为冠心病的患者先后行64层螺旋CT冠状动脉成像机冠状动脉造影检查,依据美国心脏病学会15段分段法,评价所有有效节段,并将两者进行对比分析。结果共评价493段冠状动脉血管,其中29段血管CT冠状动脉成像与CAG结果不符;以CAG作为"金标准",CT冠状动脉成像检出冠状动脉狭窄的敏感度、特异度、阳性预测值和阴性预测值分别为91.6%、95.4%、91.0%和95.7%。结论 64层螺旋CT冠状动脉成像与CAG在诊断冠心病方面有较高的一致性,64层螺旋CT冠状动脉成像可以对斑块性质做出评价,但对小血管狭窄的评估不及CAG。

Purpose To explore the commonality and disparity between 64-slice CT coronary artery imaging and coronary angiography （CAG） for the diagnosis of coronary heart disease, and to provide evidence for clinical diagnosis.Materials and Methods Forty-nine patients with suspected coronary heart disease （CHD） underwent both 64-slice CT coronary artery imaging and conventional coronary artery angiography, all available coronary segments were evaluated using a 15-segment modified AHA classification, and the results of both methods were compared and analyzed.Results 493 segments of coronary artery were evaluated, results of 29 segments were incongruent between 64-slice CT coronary artery imaging and CAG. With CAG as the gold standard, the sensitivity, specificity, positive predictive value and negative predictive value of CT coronary artery imaging for the diagnosis of coronary artery stenosis were 91.6%, 95.4%, 91.0% and 95.7% respectively.Conclusion There is a high consistency between 64-slice CT coronary artery imaging and CAG for diagnosing CHD, 64-slice CT coronary artery imaging can be used to evaluate the nature of artery plaque, but it is inferior to CAG in diagnosing small angiostenosis.