256层螺旋CTA在冠状动脉狭窄及斑块诊断中的应用价值

Value of 256-slice spiral CTA in the diagnosis of coronary artery stenosis and plaque

目的探讨256层螺旋CT动脉血管造影(CTA)对冠状动脉狭窄及不同性质斑块的诊断价值。方法2014年3月至2019年4月期间襄城县人民医院CT室对68例冠心病患者行256层螺旋CTA检查及冠状动脉造影(CAG),以CAG结果为参考标准,评估256层CTA对不同性质斑块所致冠状动脉狭窄的敏感度、特异度、阳性预测值、阴性预测值及诊断符合率,并分析冠状动脉斑块的性质。结果68例患者中,256层CTA诊断符合率为95.6%(65/68)。CTA对冠状动脉轻度狭窄的敏感性、特异性、阳性预测值、阴性预测值分别为100.0%、96.6%、97.5%、100.0%;CTA对冠状动脉中度狭窄的敏感性、特异性、阳性预测值、阴性预测值分别为88.2%、98.0%、93.8%、96.2%;CTA对冠状动脉重度狭窄的敏感性、特异性、阳性预测值、阴性预测值分别为91.7%、98.2%、91.7%、98.2%。CTA诊断68例冠状动脉斑块,其中软斑块11例(16.2%)、纤维斑块11例(16.2%)、混合斑块21例(30.9%)、钙化斑块25例(36.8%)。结论CTA能够有效判断冠状动脉狭窄程度及斑块成分,对冠状动脉狭窄程度及斑块有很大诊断价值,可作为医院首选检查方法。

Objective To evaluate the diagnostic value of 256-slice spiral CT angiography(CTA)for coronary artery stenosis and plaques with different properties.Methods Between March 2014 and April 2019,68 patients with coronary artery disease were examined by 256-slice spiral CTA and coronary angiography in the CT room of Xiangcheng County People's Hospital.Using CAG results as a reference standard,the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic coincidence rate were evaluated for 256-slice CTA in coronary artery stenosis caused by plaques with different properties,and the properties of coronary artery plaques were analyzed.Results Among the 68 patients,the diagnostic coincidence rate of 256-slice CTA was 95.6%(65/68).The sensitivity,specificity,positive predictive value,and negative predictive value of CTA were 100.0%,96.6%,97.5%,100.0%for mild stenosis of coronary artery;88.2%,98.0%,93.8%,96.2%for moderate stenosis of coronary artery;91.7%,98.2%,91.7%,98.2%for severe stenosis of coronary artery.A total of 68 coronary artery plaques were diagnosed by CTA,including soft plaques in 11 cases(16.2%),fibrous plaques in 11 cases(16.2%),mixed plaques in 21 cases(30.9%),and calcified plaques in 25 cases(36.8%).Conclusion CTA can effectively determine the degree of coronary artery stenosis and plaque composition,and has great diagnostic value for coronary artery stenosis and plaque.It can be used as the preferred examination method in hospitals.