宝石能谱CT在诊断冠心病中的应用价值

目的：探讨能谱CT在诊断冠状动脉狭窄中的应用价值。方法回顾性分析50例确诊为冠心病的患者冠状动脉CTA的影像特点，并与冠脉造影（CAG）检查比较，计算出冠脉CTA在诊断冠脉狭窄中准确率。结果本组50例病例共647段冠脉，其中左冠状动脉主干（LM）50段、回旋支（LCX）100段、左前降支（LAD）150段、对角支（DB）79段、钝缘支（OM）共68段，右冠状动脉（RCA）共150段，锐缘支（AM）共50段，其中CTA的诊断结果为：正常234段，轻度狭窄185段，中度狭窄137段，重度狭窄91段，阳性率为63.83%，含有钙化241段，心肌桥138段。CAG的诊断结果为：正常362段，轻度狭窄99段，中度狭窄103段，重度狭窄83段，阳性率为44.05%。结论能谱CT在诊断冠心病与CAG具有一致性，对中重度冠脉狭窄以及正常冠脉的诊断具有较高的准确性，可作为筛查、诊断中重度冠心病的首选检查方法。

ObjectiveTo investigate the value of the spectral CT in diagnosis of coronary artery stenosis.MethodsCoronary artery CTA imagings features of 50 cases diagnosed as coronary heart disease were retrospectively analyzed,compared with coronary angiography（CAG）,and calculated the diagnostic accurate rate of the coronary CTA was calculated.ResultsThere were 50 cases with 647 coronary segments in this group, including LM in 50 segments,LCX in 100 segments,LAD in 150 segments,DB in 79 segments,OM in 68 segments,RCA in 150 segments, AM in 50 segments. And the result of CTA were：normal in 234 segments,mild stenosis in 185 segments,moderate stenosis in 137 segments, severe stenosis in 91 segments,containing calcified in 24 segments,myocardial bridge in 138 segments,and the total positive rate was 73.83%. CAG diagnostic Results were as follows：normal 362 segments,99 segments with mild stenosis,103 segments with moderate stenosis,83 segments with severe stenosis,and the positive rate was 44.05%.ConclusionThe value of CTA in the diagnosis of coronary artery disease was consistent with the CAG. With higher accuracy in the diagnosis of moderate-severe coronary stenosis and normal coronary artery,the coronary CTA can be used as the preferred method in the screening and diagnosis of coronary heart disease.