256螺旋CT冠脉成像诊断老年人冠脉狭窄的应用价值

Application value of 256 slice spiral CT coronary angiography for diagnosing coronary artery stenosis in aged patients

目的:研究观察256层螺旋CT冠状动脉成像(MSCT)诊断老年冠状动脉狭窄的临床应用价值。方法:选择我院收治的疑似冠状动脉狭窄的老年患者95例为研究对象,分别进行MSCT和冠状动脉造影(CAG)检查,对两种诊断方法的检查结果进行综合比较。结果:(1)CAG诊断冠状动脉狭窄患者阳性91例、阴性4例;MSCT诊断结果阳性89例、阴性6例,两组诊断结果比较有高度一致性(Kappa=0.789,P=0.001),提示MSCT能够达到CAG的诊断效果;(2)MSCT诊断冠状动脉狭窄的灵敏度、特异度、阳性预测值、阴性预测值、准确度分别为:94.51%、25.00%、96.63%、16.67%、91.58%,提示MSCT诊断结果有较高的准确性;(3)MSCT和CAG在冠状动脉狭窄程度的判断比较,差异无统计学意义(P=0.524)。结论:256层MSCT对老年冠状动脉狭窄的诊断准确度高,与金标准CAG的诊断效果基本一致,且操作简便,无创伤性,可在临床上推广应用,唯特异度较差,要适当注意。

Objective: To study and observe application value of 256 slice spiral CT coronary imaging (MSCT) for diagnosing coronary artery stenosis in aged patients. Methods: A total of 95 aged patients suspecting coronary artery stenosis treated in our hospital were selected. They received MSCT and coronary angiography (CAG) respectively. Inspecting outcomes of above two diagnostic methods were comprehensively compared. Results:(1)CAG identified 91 positive cases and four negative cases in diagnosing coronary artery stenosis, while it's 89 positive cases and six negative cases for MSCT. The diagnostic outcomes of two methods were highly consistent (Kappa=0.789, P =0.001), suggesting MSCT can achieve the diagnostic effect of CAG;(2)Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MSCT diagnosing coronary artery stenosis was 94.51%, 25.00%, 96.63%, 16.67% and 91.58% respectively, suggesting diagnostic outcomes of MSCT possessed high accuracy;(3)There was no significant difference in judgment of coronary artery stenosis degree between MSCT and CAG, P =0.524. Conclusion: The diagnostic accuracy of 256 slice MSCT is high in aged patients with coronary artery stenosis, which is almost consistent with that of the gold standard-CAG. The conduction is simple and it's noninvasive, which can be extended in clinic;but it′s specificity is compare less, must pay suitable intension.