256层CT血管成像与64层CT在冠状动脉狭窄中的诊断价值比较

Comparison on the diagnostic value of 256-slice CT angiography and 64-slice CT in coronary artery stenosis

目的分析256层CT血管成像(CTA)技术与64层CT在冠状动脉狭窄诊断价值比较。方法选择2018年1月—2019年8月本院收治的疑似冠状动脉狭窄患者104例作为研究对象,随机分为研究组和对照组两组,每组各52例。研究组行256层CTA技术检查,对照组行64层CT检查,均以数字减影血管造影(DSA)为金标准,统计比较两组的诊断敏感度、特异度、准确率;分析256层CTA技术与DSA冠状动脉狭窄程度符合率。结果研究组诊断冠状动脉狭窄的敏感度为97.30%(36/37)、特异度为93.33%(14/15)、准确度为96.15%(50/52),高于对照组的76.32%(29/38)、50.00%(7/14)、69.23%(36/52),差异均有统计学意义(P<0.05);256层CTA技术与DSA诊断冠状动脉狭窄程度符合率为81.08%(30/37),Kappa指数为0.867,差异有统计学意义(P<0.05);256层CTA技术冠脉狭窄节段检出率与DSA一致性较高,Kappa值为0.889,差异有统计学意义(P<0.05)。结论256层CTA技术诊断冠状动脉狭窄的敏感度、特异度、准确率较高,可清晰显示冠状动脉影像,为临床治疗方案选择提供可循证依据。

Objective To analyze the diagnostic value of 256-slice CT angiography(CTA)and 64-slice CT in the diagnosis of coronary artery stenosis.Methods 104 cases of patients with suspected coronary artery stenosis those admitted to our hospital from January 2018 to August 2019 were selected as the research objects,and they were divided into two groups of research group and control group randomly,with 52 cases in each group.Patients in the research group for 256-layer CTA technical examination,and for patients in control group,a 64-slice CT examination was performed.Take the digital subtraction angiography(DSA)as the gold standard,and statistically compared the sensitivity,specificity,accuracy of the two groups.The coincidence rate of 256-slice CTA technology in diagnosing coronary artery stenosis with DSA was analyzed.Results The sensitivity of the 256-slice CTA technique in diagnosing coronary artery stenosis was 97.30%(36/37),the specificity was 93.33%(14/15),and the accuracy was 96.15%(50/52),all of the indicators were higher than 76.32%(29/38),50.00%(7/14),69.23%(36/52)of the 64-slice CT,the differences were statistically significant(P<0.05).The coincidence rate of 256-layer CTA technique with DSA in diagnosis of coronary artery stenosis was 81.08%(30/37),and the Kappa index was 0.867,the difference was statistically significant(P<0.05).The detection rate of coronary stenosis segment with 256-layer CTA technique was well consistent with DSA,and the Kappa value was 0.889,the difference was statistically significant(P<0.05).Conclusions The 256-layer CTA technique presents high sensitivity,specificity and accuracy in diagnosing coronary artery stenosis,it could clearly display coronary artery images and provide evidence-based basis for the selection of clinical treatment options.