摘要
目的:分析不同程度钙化斑块对320排动态容积CT冠状动脉成像(320-CCTA)评估冠脉狭窄的影响。方法:回顾性分析161例接受320-CCTA检查,并于4周内接受冠状动脉造影(CAG)检查的冠心病疑诊患者的临床资料。以CAG为"金标准",判断320-CCTA诊断伴不同程度钙化斑块冠状动脉狭窄的准确性;对照CAG结果,绘制320-CCTA的受试者工作特征曲线(ROC曲线)并计算曲线下面积(AUC)值。结果:161例320-CCTA图像质量为4分121例(占75.2%),3分40例(占24.8%)。全部病例无阶梯伪影及运动伪影。182(占7.9%)冠脉节段中发现不同程度钙化斑块,其中轻度钙化斑块136(占5.9%)、中度钙化斑块39(占1.7%)、重度钙化斑块7(占0.3%)。320-CCTA诊断冠状动脉狭窄≥50%的敏感性、特异性:非钙化斑组为98.3%、81.3%,混合斑块组为100%、86.2%,轻度钙化78.6%、99.2%,中度钙化90%、86.2%,重度钙化100%、66.7%,其ROC曲线AUC值分别为0.90、0.93、0.89、0.88和0.83。结论:受重度钙化影响,320-CCTA诊断冠脉狭窄≥50%的准确性有所降低,但总体上具有较高的准确性。
Objective:To investigate the diagnostic accuracy of 320-slice dynamic volume coronary CT angiography(320-CCTA) in detecting coronary stenosis and to analyze the impact of coronary calcium in different calcification burden groups.Methods:The retrospective analysis enrolled 161 cases undergoing 320-CCTA and thereafter invasive coronary angiography(CAG) within 4 weeks for suspected coronary artery disease.Compared to CAG,the pretest probability of coronary stenosis was analyzed; the receiver operation characteristic(ROC) curve and area under curve of ROC(AUC) were used for statistical analyses.Results:Of 161 patients,121 cases(75.2%) with optimal imaging quality(scale 4),40 patients(24.8%) with adequate quality(scale 3).No any stairstep artifact or motion artifact in all cases.A total of 182(7.9%) segments had some degree of calcification,of all segments,136(5.9%) had lightly calcification,39(1.7%) had moderate calcification,7(0.3%) had severely calcification.The sensitivity and specificity of 320-CCTA for detecting coronary stenosis were at least 50%:noncalcified plaque group(NCP) 98.3%,81.3%,mixture plaque group(MP) 100%,86.2%,lightly calcified plaque group(LCP) 78.6%,99.2%,moderately calcified plaque group(MCP) 90%,86.2%,severely calcified plaque group(SCP) 100%,66.7%,the AUC was 0.90,0.93,0.89,0.88,0.83,respectively.Conclusion:Generally 320-CCTA provides high diagnostic accuracy; but the accuracy will be decreased due to severely calcification.
出处
《温州医学院学报》
CAS
2015年第8期570-573,578,共5页
Journal of Wenzhou Medical College
基金
温州市公益性科技计划项目(Y20140613)