64排能谱螺旋CT冠状动脉成像诊断冠状动脉狭窄和冠心病的价值

Diagnostic value of 64-slice energy spectrum spiral CT coronary angiography in coronary artery stenosis and coronary heart disease

目的分析64排能谱螺旋CT(multi-slice computed tomography,MSCT)冠状动脉成像(coronary angiography,CTA)诊断冠状动脉狭窄、冠心病的价值。方法选取2014年4月-2015年9月我院收治的62例疑似冠心病患者临床资料,给予患者64排能谱MSCT诊断(设为观察组)和冠状动脉常规造影诊断(设为对照组),观察比较两组诊断结果准确度和精确度。结果观察组检出阳性率为88.71%(55/62),较对照组阳性率74.19%(46/62)高,差异有统计学意义(P<0.05)。两组各部位病灶分布比例差异不明显(P>0.05);对照组准确度79.03%、灵敏度75.81%、特异度74.19%、阳性预测值73.91%、阴性预测值75.01%,均较观察组的93.55%、88.71%、85.48%、85.19%、87.51%低,差异有统计学意义(P<0.05);观察组脂质斑块斜率较纤维斑块、斑块内出血斜率低,内出血斜率则较纤维斑块斜率低,差异有统计学意义(P<0.05)。结论采用64排能谱MSCT诊断冠状动脉狭窄和冠心病检测效果良好,可快速、准确检出动脉血管狭窄病灶,精确度高,具有临床推广价值。

Objective To analyze the value of 64-slice energy spectrum spiral CT （MSCT） coronary an-giography （CTA） in the diagnosis of coronary artery stenosis and coronary heart disease. Methods The clinical data of 62 patients with suspected coronary heart disease treated in our hospital from April 2014 to September 2015 were analyzed. All the patients were given MSCT diagnosis （the observation group） and coronary angiogra-phy （the control group）, then the accuracy and accuracy of diagnostic results with two groups were observed and compared. Results The positive rate of the control group was 74.19%, which lower than that of the observation group （88.71%）（P〈0.05）. There was no signifcant difference in the distribution of lesion between the two groups （P〉0.05）. The accuracy of the control group was 79.03%; the sensitivity was 75.81%; the specifcity was 74.19%; the positive predictive value was 73.91% and the negative predictive value was 75.01%, and those in the observa-tion group were 93.55%, 88.71%, 85.48%, 85.19% and 87.51%, respectively （P〈0.05）. The slope of lipid plaque in the observation group was lower than that in the fbrous plaques, and the slope of the bleeding was lower than that of the fbrous plaque （P〈0.05）. Conclusion 64-slice energy spectrum spiral CT could be used to diagnose coronary artery disease and coronary heart disease. The results of rapid and accurate detection of arterial steno-sis were high accuracy and clinical value.