CT冠状动脉成像中钙化斑块特征对血管狭窄诊断结果的影响

Influence of Calcified Plaque Characteristics on the Diagnostic Results of Vascular Stenosis in CT Coronary Angiography

【目的】探讨CT冠状动脉成像中钙化斑块特征对血管狭窄诊断结果的影响。【方法】本院收治的102例存在钙化斑块的冠心病患者作为观察组,另选取本院同期接受治疗的80例无钙化斑块的冠心病患者为对照组。所有患者均行CT冠状动脉成像和数字减影血管造影(DSA)检查钙化斑块特征,分析不同程度斑块钙化对CT冠脉造影诊断血管狭窄程度的影响。【结果】观察组102例有钙化斑块的冠心病患者中,共189处出现狭窄情况,其中由非钙化斑块引起的狭窄54处,轻中度钙化斑块引起的狭窄78处,重度钙化斑块引起的狭窄57处。CT冠脉造影诊断结果对于非钙化斑块的诊断与DSA诊断的一致性高(Kappa=0.904,P<0.05),对轻中度钙化斑块与DSA诊断一致性较高(Kappa=0.822,P<0.05),对重度斑块与DSA诊断一致性一般(Kappa=0.541,P<0.05)。对照组80例患者,经DSA诊断,共98处发生狭窄,其中53处为不明显狭窄,45处为明显狭窄。CT冠脉造影与DSA诊断结果一致性较高(Kappa=0.979,P<0.05)。轻中度钙化斑块与重度钙化斑块的灵敏度比较,差异无统计学意义(P>0.05);轻中度、重度钙化斑块诊断的特异性和准确率比较,差异有统计学意义(P<0.05)。【结论】在钙化斑块存在的情况下,CT冠脉造影诊断血管狭窄的敏感性较高,特异性较低,且重度钙化斑块存在对特异性的影响较为严重。

【Objective】To investigate the influence of calcified plaque characteristics on the diagnostic results of vascular stenosis in CT coronary angiography.【Methods】A total of 102 coronary heart disease patients with calcified plaques treated in our hospital were selected as the observation group,and 80 coronary heart disease patients without calcified plaques treated during the same period were selected as the control group.All patients underwent CT coronary angiography and digital subtraction angiography(DSA)to examine the characteristics of calcified plaques.To analyze the impact of different degrees of plaque calcification on the diagnosis of vascular stenosis by CT coronary angiography.【Results】In the observation group of 102 patients with calcified plaques,189 sites of stenosis were identified,including 54 sites caused by non-calcified plaques,78 sites by mildly to moderately calcified plaques,and 57 sites by severely calcified plaques.The diagnostic consistency between CT coronary angiography and DSA was high for non-calcified plaques(Kappa=0.904,P<0.05),relatively high for mildly to moderately calcified plaques(Kappa=0.822,P<0.05),and moderate for severely calcified plaques(Kappa=0.541,P<0.05).In the control group of 80 patients,DSA diagnosed 98 sites of stenosis,including 53 sites of mild stenosis and 45 sites of significant stenosis.The diagnostic consistency between CT coronary angiography and DSA was high(Kappa=0.979,P<0.05).The sensitivity comparison between mildly to moderately calcified plaques and severely calcified plaques showed no statistical significance(P>0.05);however,there were statistically significant differences in the specificity and accuracy between the two groups(P<0.05).【Conclusion】In the presence of calcified plaques,CT coronary angiography demonstrates high sensitivity but low specificity in diagnosing vascular stenosis.And the presence of severe calcified plaques has more significantly impact on the specificity.