冠脉CT成像技术对冠心病患者病变程度的诊断分析

Diagnostic Analysis of Coronary CT Angiography in the Degree of Coronary Heart Disease

目的:探讨冠脉CT血管成像技术(CTA)诊断冠心病患者病变程度的临床价值。方法:选取2019年1月—2022年1月泉州市光前医院收治的疑似冠心病患者264例,分别开展冠状动脉造影(CAG)、CTA检查,将CAG当作金标准,就CTA诊断冠心病病变程度、部位的一致性进行对比,另比较诊断的准确度、敏感度与特异度。结果:264例患者,CAG诊断中度狭窄92例,重度狭窄138例,其余患者无狭窄或狭窄程度低于50%。CTA诊断中度狭窄程度的Kappa值为0.694,重度狭窄程度的Kappa值为0.796,两者均具有高度的一致性。中度狭窄程度,敏感度为95.65%,准确度为94.12%,特异度为80.00%;重度狭窄程度,敏感度为94.93%,准确度为94.44%,特异度为91.67%。CTA诊断病变部位在左前降支、右冠脉、左回旋支的Kappa值分别为0.815、0.866、0.533,在左前降支、右冠脉方面具有最强的一致性,在左回旋支方面具有中度的一致性。诊断病变部位在左前降支、左回旋支、右冠脉的敏感度、准确度、特异度分别为97.12%、95.80%、86.67%,90.00%、89.39%、83.33%,96.97%、96.20%、92.31%。结论:CTA在诊断中度狭窄程度、重度狭窄程度方面,具有高度的一致性,CTA在诊断病变部位在左回旋支方面,具有中度的一致性,在诊断病变部位在右冠脉、左前降支方面,具有最强的一致性。

Objective:To explore the clinical value of coronary CT angiography(CTA)in the diagnosing the degree of coronary heart disease.Method:A total of 264 patients with suspected coronary heart disease who admitted to Quanzhou Guangqian Hospital from January 2019 to January 2022 were selected to carry out coronary angiography(CAG)and CTA respectively.CAG was used as the gold standard to compare the consistency of CTA in diagnosing the degree and location of coronary heart disease,and the accuracy,sensitivity and specificity of diagnosis.Result:Among 264 patients,92 patients were diagnosed as moderate stenosis and 138 patients were diagnosed as severe stenosis by CAG,and other patients had no stenosis or the degree of stenosis was less than 50%.Kappa value of CTA in the diagnosis of moderate stenosis was 0.694,Kappa value of severe stenosis was 0.796,both were highly consistent.Moderate stenosis:the diagnostic sensitivity was 95.65%,the accuracy was 94.12%,and the specificity was 80.00%;severe stenosis:the sensitivity was 94.93%,the accuracy was 94.44%and the specificity was 91.67%.Kappa values of left anterior descending artery,right coronary artery and left circumflex artery were 0.815,0.866 and 0.533,respectively,which had the strongest consistency in left anterior descending artery and right coronary artery and moderate consistency in circumflex artery.The sensitivity,accuracy and specificity of the diagnosis of the lesion in the left anterior descending branch,left circumflex branch and right coronary artery were 97.12%,95.80%,86.67%,90.00%、89.39%、83.33%,96.97%,96.20%and 92.31%,respectively.Conclusion:CTA has high consistency in the diagnosis of moderate and severe stenosis.CTA has moderate consistency in the diagnosis of the lesion in the left circumflex branch,CTA has the strongest consistency in the diagnosis of the lesion in the right coronary artery and the anterior descending branch.