冠状动脉CT血管造影对冠心病病变情况的诊断价值

Diagnostic Value of Coronary Artery CT Angiography on the Pathological Condition of Coronary Heart Disease

目的:探讨冠状动脉CT血管造影(CCTA)对冠心病(CHD)病变情况的诊断价值。方法:回顾性选取荆门市中医医院2018年9月-2021年9月收治的200例CHD患者的临床资料。所有患者入院后给予CCTA、冠状动脉造影(CAG)检查。以CAG检查结果作为金标准,分析CCTA对冠状动脉不同狭窄程度、不同病变支数、不同病变部位的检出结果。分析CCTA对冠状动脉不同狭窄程度、不同病变支数、不同病变部位的诊断效能。分析典型病例图片。结果:200例患者经金标准检查诊断冠状动脉重度狭窄为103例,中度狭窄72例。经CCTA检查诊断为冠状动脉重度狭窄109例,非重度狭窄91例,99为真实重度狭窄;中度狭窄89例,非中度狭窄111例,68例为真实中度狭窄。200例患者经金标准检查诊断冠状动脉多支病变87例,单支病变113例。经CCTA检查诊断为冠状动脉多支病变95例,单支病变105例。200例患者经金标准检查诊断右冠脉(RCA)病变50例,左前支(LAD)病变78例,左回旋支(LCX)病变39例。经CCTA检查诊断为RCA病变64例,非RCA病变136例,49例为真实RCA病变;LAD病变86例,非LAD病变114例,76例为真实LAD病变;LCX病变66例,非LCX病变134例,37例为真实LCX病变。CCTA诊断冠状动脉不同病变支数敏感度为94.25%,特异度为88.50%,准确度为91.00%。CCTA诊断冠状动脉不同狭窄程度、病变支数、病变部位均具有较高的特异度、准确度、敏感度,CCTA诊断冠状动脉中度狭窄、LCX病变的特异度较低。结论:CCTA可对CHD患者冠状动脉不同狭窄程度、病变支数、病变部位的情况进行精准判断,具有较高的特异度、准确度、敏感度,可为CHD患者的临床诊断及病情评估提供重要参考。

Objective:To investigate the diagnostic value of coronary artery CT angiography (CCTA) on the pathological condition of coronary heart disease (CHD).Method:The clinical data of 200 patients with CHD admitted to Jingmen Hospital of Traditional Chinese Medicine from September 2018 to September 2021 were retrospectively selected.All patients were examined by CCTA and coronary angiography (CAG) after admission.The results of CAG were used as the gold standard to analyze the detection results of CCTA on the different stenosis degree,different lesion branches and different lesion position of coronary artery.The diagnostic efficacy of CCTA on the different stenosis degree,different lesion branches and different lesion position of coronary artery was analyzed.The pictures of typical cases were analyzed.Result:Among 200 patients,103 patients with severe coronary stenosis and 72 patients with moderate coronary stenosis were diagnosed by gold standard examination;109 cases of severe coronary stenosis,91 cases of non severe coronary stenosis and 99 cases of true severe coronary stenosis were diagnosed by CCTA;there were 89 cases of moderate stenosis,111 non moderate stenosis and 68 true moderate stenosis.Among 200 patients,87 patients with multiple coronary artery pathological changes and 113 patients with single coronary artery pathological changes were diagnosed by gold standard examination.By CCTA examination,95 cases with multiple coronary artery pathological changes and 105 cases with single coronary artery pathological changes were diagnosed;50 cases of right coronary artery (RCA) pathological changes,78 cases of left anterior branch (LAD) pathological changes and 39 cases of left circumflex branch (LCX) pathological changes were diagnosed by gold standard examination in 200 patients;64 cases of RCA pathological changes,136 cases of non RCA pathological changes and 49 cases of real RCA pathological changes were diagnosed by CCTA examination;there were 86 LAD pathological changes,114 non LAD pathological changes and 76 true LAD pathological changes;there were 66 LCX pathological changes,134 non LCX pathological changes and 37 true LCX pathological changes.The sensitivity,specificity and accuracy of CCTA in diagnosing the number of branch in different coronary artery pathological changes were 94.25%,88.50% and 91.00% respectively.CCTA had high specificity,accuracy and sensitivity in diagnosing coronary artery different stenosis degree,number of lesion branches and pathological changes location,while CCTA had low specificity in diagnosing moderate coronary artery stenosis and LCX pathological changes.Conclusion:CCTA can accurately judge the coronary artery different stenosis degree,the lesion branches and the lesion position in CHD patients,with high specificity,accuracy and sensitivity.It can provide important reference for clinical diagnosis and disease evaluation of CHD patients.