急性胸痛诊断中64排128层螺旋CT联合三联检查的应用效果分析

Analysis of the Application Effect of 64 Row 128 Slice Spiral CT Combined with Triple Examination in the Diagnosis of Acute Chest Pain

目的:分析急性胸痛诊断中64排128层螺旋CT联合三联检查的应用效果。方法:将2021年9月-2022年12月我院收治的急性胸痛住院患者68例作为研究对象,分别采用64排128层螺旋CT三联检查以及常规CT扫描,将进行64排128层螺旋CT三联检查者纳入观察组(n=68),常规CT扫描者纳为对照组(n=68)。对比两组图像质量、扫描参数并绘制ROC曲线,分析64排128层螺旋CT联合三联检查对患者的诊断效果。结果:金标准诊断出阳性64例,阴性4例,其中急性冠脉综合征者52例,肺栓塞6例,主动脉夹层6例;128层螺旋CT三联检查共诊断出60例阳性,阴性8例,其中急性冠脉综合征者50例,肺栓塞6例,主动脉夹层4例;常规CT扫描共诊断出54例阳性,阴性14例,其中急性冠脉综合征者48例,肺栓塞3例,主动脉夹层3例;观察组扫描长度、有效剂量以及剂量长度乘积均高于对照组,差异有统计学意义(均P<0.05);常规CT扫描的AUC值为0.9060,灵敏度为81.30%,特异度为50.00%,95%CI为0.7890-0.8350;128层螺旋CT三联检查的AUC值为0.9530,灵敏度为90.60%,特异度为50.00%,95%CI为0.8770-0.9930。结论:急性胸痛诊断中64排128层螺旋CT三联检查较常规CT扫描具有更高的灵敏度,且扫描参数较好。

Objective:To analyze the application effect of 64 row 128 slice spiral CT combined with triple examination in the diagnosis of acute chest pain.Methods:68 patients with acute chest pain admit⁃ted to our hospital from September 2021 to December 2022 were selected as the research object.64 row 128 slice spiral CT triple examination and conventional CT scan were used respectively.Those who un⁃derwent 64 row 128 slice spiral CT triple examination were included in the observation group(n=68),and those who underwent conventional CT scan were included in the control group(n=68).The image quality and scanning parameters of the two groups were compared,and ROC was drawn to analyze the diagnostic effect of 64 row 128 slice spiral CT combined with triple examination on patients.Results:The gold stan⁃dard diagnosed 64 positive cases and 4 negative cases,including 52 cases of acute coronary syndrome,6 cases of pulmonary embolism and 6 cases of aortic dissection.A total of 60 positive and 8 negative cases were diagnosed by 128 slice spiral CT,including 50 cases of acute coronary syndrome,6 cases of pulmonary embolism,and 4 cases of aortic dissection.A total of 54 positive and 14 negative cases were diag⁃nosed by conventional CT scan,including 48 cases of acute coronary syndrome,3 cases of pulmonary em⁃bolism and 3 cases of aortic dissection.Scanning length,effective dose and dose-length product of obser⁃vation group were higher than those of control group,and the differences were statistically significant(all P<0.05).The AUC value of conventional CT scan was 0.9060,the sensitivity was 81.30%,the specificity was 50.00%,and the 95%CI was 0.7890-0.8350.The AUC value,sensitivity,specificity and 95%CI of 128 slice spiral CT were 0.9530,90.60%,50.00%and 0.8770-0.9930 respectively.Conclusion:In the di⁃agnosis of acute chest pain,the 64 row 128 slice spiral CT triple scan has higher sensitivity and better scanning parameters than conventional CT scan.