冠脉CTA诊断冠心病的临床价值

Clinical Value of Coronary CTA in Diagnosis of Coronary Heart Disease

目的:探讨冠脉CTA诊断冠心病的临床价值。方法:选取2017年4月-2019年2月笔者所在医院52例临床疑诊冠心病患者,患者均接受冠脉CTA检查并于检查后1个月内完成冠脉造影检查,比较观察两种方法病变血管检出情况,评价诊断一致性。结果:冠脉CTA检出左主干病变9.62%,前降支病变67.31%,回旋支病变48.08%,右冠脉病变46.15%,各血管段病变检出数与冠脉造影比较,差异均无统计学意义(P>0.05)。基于冠脉造影金标准,冠脉CTA诊断冠心病灵敏度95.74%、特异度100%、符合率94.23%,Kappa检验与冠脉造影诊断冠心病结果具有高度一致性(κ=0.832)。结论:冠脉CTA病变血管检出率及冠心病诊断灵敏度、特异度等同冠脉造影基本相当,能够为临床提供有价值的影像学依据,可作为冠心病首选诊断方法应用推广,但仍存在一定误诊率,尚不能替代冠脉造影金标准。

Objective:To investigate the clinical value of coronary CTA in the diagnosis of coronary heart disease.Method:A total of 52 patients with suspected coronary heart disease in our hospital from April 2017 to February 2019 were selected.All patients received coronary CTA examination and completed coronary angiography within 1 month after the examination.The detection of diseased vessels in the two groups was compared and observed to evaluate the diagnostic consistency.Result:Coronary CTA detected left main artery lesion of 9.62%,anterior descending artery lesion of 67.31%,cyclotron artery lesion of 48.08%,right coronary artery lesion of 46.15%,there was no statistical difference between two groups in the number of lesions detected in each segment and coronary angiography(P>0.05).Based on the gold standard of coronary angiography,coronary CTA had a sensitivity of 95.74%,a specificity of 100% and a coincidence rate of 94.23%.The results of Kappa test were highly consistent with those of coronary angiography(κ=0.832).Conclusion:The detection rate of coronary artery CTA lesions and the diagnostic sensitivity and specificity of coronary artery disease are equivalent to that of coronary angiography,which can provide valuable imaging basis for clinical practice and can be used as the preferred diagnostic method for coronary heart disease.However,there is still some misdiagnosis rate,which cannot replace the gold standard of coronary angiography.