MSCT一站式检查急性胸痛三联征患者的临床价值

The clinical value of multi-slice spiral CT one-stop combined examination for screening acute triple chest pain lesions

目的 探讨多层螺旋CT(MSCT)一站式检查急性胸痛三联征患者的临床价值。方法 选取急性胸痛三联征患者96例,均予以MSCT一站式联合筛查(肺动脉CTA、主动脉CTA、冠状动脉CT扫描),以冠状动脉造影检查为金标准,同时分析MSCT检查后患者主动脉、肺动脉及冠状动脉组织结构重构,分析图像质量及诊断效能。结果 96例急性胸痛三联征病变患者中,冠状动脉狭窄病变49例(单支病变23例、双支病变14例,三支病变12例);主动脉夹层动脉瘤10例,肺栓塞10例,心包炎8例,气胸7例,肺部感染6例,胸腔积液6例。MSCT检查诊断率92.71%,灵敏度93.18%,特异度87.50%,与冠状动脉造影检查对比中差异无统计学意义(P>0.05)。96例患者中总计1245段冠状动脉图像,其中优、良、差占比分别为82.01%、12.93%、5.06%。结论 MSCT一站式检查急性胸痛三联征能及时准确提示病因,具有重要临床意义。

Objective To explore the value of multi-slice spiral CT one-stop combined examination in screening acute chest pain triad lesions.Methods 96 patients with suspected acute chest pain triad lesions admitted to the emergency department from November 2021 to October 2023 were selected.All patients underwent a one-stop combination screening with multi-slice spiral CT(pulmonary artery CTA,aortic CTA,coronary CT scan integration),with coronary angiography as the gold standard.At the same time,the reconstruction of the tissue structure of the patient's aorta,pulmonaryartery,and coronary artery after spiral CT examination was analyzed,and the image quality and diagnostic efficacy were analyzed.Results Among 96 suspected patients with acute chest pain triad lesions,a total of 49 cases of coronary artery stenosis lesions were detected(23 cases of single vessel lesions,14 cases of double vessel lesions,and 12 cases of triple vessel lesions);There were 10 cases of aortic dissection aneurysm,10 cases of pulmonary embolism,8 cases of pericarditis,7 cases of pneumothorax,6 cases of pulmonary infection,and 6 cases of pleural effusion.Under multi-slice spiral CT examination,the diagnostic rate was 92.71%,sensitivity was 93.18%,specificity was 87.50%,and there was no difference compared with coronary angiography examination,P<0.05;Out of 96 patients,a total of 1245 coronary artery images were obtained,with excellent,good,and poor proportions of 82.01%,12.93%,and 5.06%respectively.Conclusion Multi slice spiral CT one-stop combined examination screening can provide clear diagnostic efficacy in the diagnosis of acute chest pain triad lesions,timely and accurately indicate the etiology of acute chest pain patients,and has important clinical significance for the diagnosis and differentiation of clinical chest pain triad lesions.