多排螺旋CT冠脉血管造影在冠心病中的应用研究

The Application of Multi Slice Spiral CT Angiography in Coronary Heart Disease

目的:以数字减影血管造影(DSA)为金标准,对比分析多排螺旋CT血管造影(CTA)评价冠状动脉狭窄的准确性及灵敏度,探讨CTA在检查冠状动脉狭窄病症的临床价值。方法:采取随机计数表法选取2014年4月至2015年4月在我院确诊冠心病或疑似病例78例,进行CTA检查,并于检查前后一周内行DSA检查,将CTA及DSA的检查结果进行对比分析,同时对病变管腔的狭窄程度及检测的特异性和灵敏度进行比较。结果:78例患者共580支血管,CTA发现440支冠状动脉狭窄;DSA发现446支冠状动脉狭窄。以DSA为标准,CTA检查诊断中度以上冠状动脉狭窄的准确度为94.96%。CTA在左主干、左前降支、左回旋支和右冠状动脉四种具体的分布部位与DSA的检查分布结果具有较高的一致性。CTA检查的钙化斑块所致的管腔狭窄的符合度为88.20%,非钙化斑块所致的管腔狭窄的符合度为90.31%。结论:多排螺旋CT冠状动脉血管造影可清楚显示冠状动脉管壁增厚及狭窄情况、动脉壁的斑块和钙化等优势,是一种诊断冠状动脉疾病的理想的无创检测方法。

Objective： With digital subtraction angiography（DSA） as the gold standard, comparative analysis of multi slice spiral CT coronary angiography（CTA） in the evaluation of coronary artery stenosis of the accuracy and sensitivity of CTA for the clinical value of the examination of coronary artery stenosis. Methods： 78 cases of patients with known or suspected coronary heart disease were selected who diagnosed in our hospital from April 2014 to April 2015, the CTA inspection, and check in a week before and after the adept DSA examination, comparing with the results of CTA and DSA examination analysis, at the same time the pathological changes of lumen stenosis degree and the detection sensitivity and specificity of the comparison. Results： A total of 78 patients, 580 vessels, CTA found 440 coronary artery stenosis; DSA found 446 coronary artery stenosis. On the basis of DSA, CTA check the accuracy of diagnosis of above moderate coronary artery stenosis was 94.96%. CTA in the left main, left anterior descending, left circumflex branch and right coronary artery four specific distribution area and distribution of DSA examination result has high consistency. CTA inspection caused by calcification plaques in the conformity degree of luminal stenosis of 88.20%, due to non calcified plaque conformity degree of luminal stenosis was 90.31%. Conclusion： Multi slice spiral CT coronary angiography can clearly display the coronary vessel wall thickening and stenosis of the arterial wall plaque and calcification of advantage, is an ideal on the diagnosis of coronary artery disease in non-invasive detection method.