多层螺旋CT血管造影在评价冠状动脉狭窄程度及斑块成分中的应用

Application of multi-slice spiral CT angiography in evaluation of coronary artery stenosis and plaque components

目的:探究多层螺旋CT血管造影(MSCTA)在评价冠状动脉狭窄程度、斑块成分中的应用价值。方法:回顾性分析2019年5月至2020年5月于南阳南石医院接受MSCTA检查与冠状动脉造影(CAG)检查(检查间隔4周内)的86例胸痛患者的资料,以CAG检查结果为金标准,评价MSCTA在冠状动脉狭窄程度、斑块成分中的应用价值。结果:86例患者共检测878段冠状动脉。CAG检测无狭窄674段,轻度狭窄99段,中度狭窄63段,重度狭窄36段,闭塞6段,诊断狭窄阳性105段;MSCTA检测无狭窄654段,轻度狭窄122段,中度狭窄41段,重度狭窄55段,闭塞6段,诊断狭窄阳性102段;Kappa值=0.840,两种检查结果一致性较好。878段受检冠状动脉中,CAG检出无斑块684段,有斑块194段;MSCTA检出无斑块654段,混合斑块92段,钙化斑块53段,非钙化斑块79段。MSCTA评价冠状动脉狭窄程度、斑块成分的灵敏度分别为94.29%和94.84%,特异度为99.61%和94.15%,准确度为98.97%和94.31%,阳性预测值为97.06%和82.14%,阴性预测值为99.23%和98.47%,均具有较高诊断效能。结论:MSCTA用于评价冠状动脉狭窄程度、斑块成分的诊断效能较好,具有较高临床应用价值。

Objective:To investigate the clinical value of multi-slice spiral computed tomography angiography(MSCTA)in evaluating the degree of coronary stenosis and plaque components.Methods:A total of 86 patients with chest pain who underwent coronary artery MSCTA examination and digital coronary artery angiography(CAG)examination(within 4 weeks)in Nanshi Hospital of Nanyang,from May 2019 to May 2020,were retrospectively analyzed.Taking CAG examination results as the gold standard,the value of MSCTA in evaluating the coronary artery stenosis degree and plaque components was evaluated.Results:A total of 878 segments of coronary arteries were detected among 86 patients.CAG detected 674 segments without stenosis,99 segments with mild stenosis,63 segments with moderate stenosis,36 segments with severe stenosis,6 segments with occlusion,and 105 segments with positive stenosis.MSCTA detected 654 segments without stenosis,122 segments with mild stenosis,41 segments with moderate stenosis,55 segments with severe stenosis,6 segments with occlusion,and 102 segments with positive stenosis.Kappa value=0.793,the results of the two tests were in good consistency.Among the 878 segments of coronary arteries,CAG detected 684 segments without plaques and 194 segments with plaques;while MSCTA detected 654 segments without plaques,92 segments with mixed plaques,53 segments with calcified plaques,and 79 segments with non-calcified plaques.The sensitivities of coronary artery MSCTA in evaluating the coronary artery stenosis degree and plaque components were 94.29%and 94.84%,and the specificities were 99.61%and 94.15%,and the accuracies were 98.97%and 94.31%,and the positive predictive values were 97.06%and 82.14%,and the negative predictive values were 99.23%and 98.47%,respectively,all with higher diagnostic efficacy.Conclusions:MSCTA has good diagnostic efficacy and high clinical value in evaluating the coronary artery stenosis degree and plaque components.