64排128层容积CT冠状动脉成像对冠心病诊断的价值

Value of Coronary Angiography in coronary heart disease diagnosis by 64-detector 128-slice volume CT

目的：探讨64排128层容积CT冠状动脉成像技术在冠心病临床诊断中的价值。材料与方法：收集2014年1月~2015年6月间在我院接受64排128层容积CT冠状动脉成像及冠状动脉造影患者的影像料32例,以冠状动脉造影结果为＂金标准＂,将冠状动脉狭窄程度≥50%判为阳性,〈50%判为阴性,对直径≥1.5mm的冠状动脉节段进行对照分析评价。结果：32例患者64排128层容积CT冠状动脉成像的图像质量均达到诊断要求,纳入64排128层容积CT冠状动脉成像与冠状动脉造影对照分析的冠脉节段数共362段,64排128层容积CT冠状动脉成像判为阴性冠脉数大于冠状动脉造影,判为阳性冠脉节段数小于冠状动脉造影,经卡方检验,无统计学差异（P〉0.05）。其中冠状动脉造影诊断阴性214段、阳性148段,64排128层容积CT冠状动脉成像诊断阴性209段、阳性153段,出现假阴性8段、假阳性13段,得出64排128层容积CT冠状动脉成像在冠状动脉管腔狭窄程度≥50%诊断的敏感性为92.90%、特异性为97.93%、阳性预测值为97.52%、阴性预测值为94.03%、准确性为95.58%。结论：64排128层容积CT冠状动脉成像是一种安全、准确的检查技术,对冠状动脉狭窄的诊断具有较高的敏感性、特异性。

Purpose： To investigate the value of Coronary Angiography in coronary heart disease diagnosis by 64-detector 128-slice volume CT. Materials and Methods： Image date of 32 patients from January 2014 to June 2015 in our hospital were enrolled in the study. 32patients underwent both coronary computed tomography angiography （CCTA） and conventional coronary angiography （CAG）. On the basis of CAG, the stenosis of all coronary segments （diameter≥ 1.5ram） was evaluated. 250% stenosis was positive, 〈50% stenosis was negative. Use chi-square test to compare each group data. With P 〈 0. 05 for the difference was statistically significant. Results： All image of 32 patients can maintain diagnostic image quality. 362 of the proximal and middle coronary segments were assessable. The number of negative stenosis in CCTA greater than the number in CAG, and the number of positive stenosis in CCTA less than the number in CAG. In CAG, 214 segments were negative, 148 segments were positive. In CCTA, 209 segments were negative, 153 segments were positive. The study had 8 false negative and 13 false positive resuhs. In the study, patient with at least one coronary segment 〉 50% stenosis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CCTA were 92.90%, 97.93%, 97.52%, 94. 03% , 95.58% respectively. Conclusion： Coronary Angiography by 64-detector 128-slice volume CT is a safe and accurate inspection technology with high sensitivity and specificity in the diagnosis of coronary heart disease.