多层螺旋CT冠脉成像在冠心病诊断中的临床应用

Clinical Application of Multislice CT Coronary Artery Imaging in the Diagnosis of Coronary Heart Disease

目的评价冠心病诊断中采用多层螺旋CT冠脉造影的临床价值,为临床诊断冠心病提供参考。方法300例疑似冠心病者以选择性冠脉造影检查为"金标准",采用多层螺旋CT冠脉成像检查,评价其准确性。结果268(89.33%)例冠心病者,32(10.67%)例非冠心病者,268例冠心病者多层螺旋CT冠脉造影阳性者265例,阴性3例,32例非冠心病者多层螺旋CT阳性2例,阴性29例;多层螺旋CT冠脉造影灵敏度98.88%,特异度93.75%,阳性预测值99.25%,阴性预测值90.91%;多层螺旋CT冠状动脉造影结果显示各个病变部位的灵敏度、特异度均较高,冠状动脉近端的血管检查结果各指标均优于冠状动脉远端的血管。结论多层螺旋CT冠脉成像灵敏度高、特异性好,安全、无创,值得在临床推广。

Objective To evaluate the clinical value of MDCT （multislice compute tomograph） coronary angiography in the diagnosis of coronary heart disease （CHD） , and provide reference for clinical diagnosis of coronary heart disease.Methods A total of 300 suspected CHD patients accepted multislice CT coronary artery imaging. The accuracy was evaluated using coronary angiography （the CAG） check as the gold standard.Results Among all the subjects, 268 had coronary heart disease （89.33%） , 32 （10.67%）had no coronary heart disease. In 268 CHD cases, 265 were positive in MDCT coronary angiography. In 32 without CHD, 2 were positive in MDCT. The sensitivity and the specificity of MDCT coronary angiography was 98.88%o and 93.75%, the positive predictive value was 99.25% and the negative predictive value was 90.91 %. MDCT coronary angiography had high sensitivity and specificity, and had better indicators in detecting the lesion site of coronary artery： blood vessels at the bottom than those at the far side.Conclusion Multislice CT coronary artery imaging has high sensitivity and specificity, and is safe and noninvasive which is worthy of clinical promotion.