多排螺旋CT冠脉血管造影诊断冠状动脉狭窄的临床价值

Clinical Value of Multislice Spiral CT Coronary Angiography in Diagnosing Coronary Artery Stenosis

目的:探究多排螺旋CT冠脉血管造影(CTA)诊断冠状动脉狭窄的临床价值。方法:选取2016年7月-2017年7月收治的70例疑似冠心病患者临床资料进行分析,所有患者均行数字减影血管造影(DSA)及CTA检查,前者为DSA组,后者为CTA组,比较两组诊断结果。结果:70例患者共获得520支可评价血管,CTA共检出410支狭窄冠状动脉,DSA共检出416支,两组狭窄冠状动脉分布检出情况差异无统计学意义(P>0.05);CTA、DSA检出冠状动脉狭窄程度均以轻度狭窄(48.78%、46.63%)、中度狭窄(30.97%、32.45%)所占比重较高(P<0.01),且以DSA作金标准,中度及以上狭窄CTA诊断准确率为94.59%;DSA与CTA检出钙化斑块分别为165个、146个,差异无统计学意义(P>0.05),将DSA作为金标准,则CTA检出钙化斑块、非钙化斑块及混合斑块符合率分别为88.48%、90.16%、91.20%。结论:冠状动脉狭窄采取CTA诊断,具有较高诊断准确率,可对冠状动脉狭窄分布、程度及斑块性质进行区分,有助于指导临床治疗方案的制定。

Objective：To study the clinical value of stenosis multislice spiral CT coronary angiography（CTA） and digital subtraction angiography（DSA） in the diagnosis of coronary artery.Method：The clinical data of 70 cases with suspicious coronary heart disease from July 2016 to July 2017 were selected.All patient received CSA and CTA examination.The former was DSA group,and the latter was CTA group.The diagnoses of both groups were compared.Result：529 assessable vessels in total were obtained from 70 patients.CTA detected stenosis in 410 coronary arteries,while DSA found stenosis in 416 coronary arteries,showing no statistically significant difference（P〉0.05）.Most of stenosis detected by CTA and DSA were mild stenosis（48.78%,46.63%） and moderate stenosis（30.97%,32.45%）（P〈0.01）.With DSA as the golden criteria,the accuracy rate of CTA for moderate and above stenosis was 94.59%,DSA and CTA found 165 and 146 calcified plaques respectively,showing no statistically significant difference（P〉0.05）.With DSA as the golden criteria,the coincidence rates of CTA for calcified plaque,non-calcified plaque and mixed plaque were 88.48%,90.16% and 91.20%.Conclusion：CTA has a high accuracy rate in diagnosing coronary stenosis.It can differentiate the distribution and degree of coronary stenosis and the nature of plaques and help guide the development of clinical therapeutic regimen.