MSCT对心肌梗死的诊断价值研究

Study on the Value of MSCT in the Diagnosis of Myocardial Infarction

目的探讨多层螺旋CT(MSCT)在心肌梗死(MI)诊断中的临床应用价值。方法选取本院心血管内科收治的90例MI患者,患者入院后24h内接受MSCT检查,以冠脉造影检查(CAG)作为金标准,探讨MSCT在诊断MI中的临床价值。结果90例患者270只冠脉分支(90×3),MSCT共诊断70支LAD狭窄病变、53支LCX狭窄病变、34支RCA狭窄病变,MSCT诊断冠脉分支病变与CAG诊断结果的符合率分别为LAD(92.11%)、LCX(86.89%)、RCA(89.47%);MSCT诊断冠脉病变的灵敏度:89.71%、特异度:90.53%、漏诊率:10.29%、误诊率:9.47%、阳性预测值:94.58%、阴性预测值:82.69%,MSCT诊断结果与CAG结果的一致性Kappa=0.785;MSCT诊断共检出斑块125枚,其中软斑块44枚(35.20%)、混合斑块29枚(23.20%)、钙化斑块52枚(41.60%)。结论 MSCT对MI患者的冠脉病变具有较高的诊断价值,与CAG诊断结果的一致性较高,同时具有无创、价廉的优势。

Objective To investigate the clinical application value of multi-slice spiral CT （MSCT） in the diagnosis of acute myocardial infarction （MI）.Methods Select the hospital treated 90 cases of cardiovascular medicine MI patients after receiving admission within 24h MSCT checks to coronary angiography （CAG） as the gold standard, to explore the clinical value of MSCT in the diagnosis of MI.Results 90 cases of 270 patients with coronary artery branches （90×3）, MSCT were diagnosed 70 LAD stenosis, 53 LCX stenosis, 34 RCA stenosis, MSCT diagnosis of coronary artery disease and CAG branch diagnostic accordance rates were LAD （92.11%）, LCA （86.89%）, RCA （89.47%）. MSCT diagnosis of coronary artery disease sensitivity： 89.71%, specificity： 90.53%, misdiagnosis rate： 10.29% misdiagnosis rate： 9.47%, positive predictive value： 94.58%, negative predictive value： 82.69%, MSCT diagnosis and CAG consistent results Kappa=0.785. MSCT diagnosis plaques were detected in 125, where soft plaque 44 （35.20%）, mixed plaque 29 （23.20%）, calcified plaque 52 （41.60%）.Conclusion MSCT MI patients having high diagnostic value of coronary artery disease, and diagnostic results CAG high consistency, both non-invasive, inexpensive advantage.