冠脉CTA检查在冠状动脉临界病变斑块诊断及评估效能研究

Study on the Efficacy of Coronary CTA in the Diagnosis and Evaluation of Critical Coronary Plaque Lesions

目的 探讨冠脉CT血管造影(CTA)在冠状动脉临界病变斑块诊断及评估效能。方法回顾性研究,以2022年3月至2024年3月经本院收治行CTA、冠状动脉造影(CAG)检查的90例患者为研究对象,以CAG为诊断金标准,分析CTA在冠状动脉临界病变斑块诊断及评估效能。结果90例患者经CAG检查显示冠状动脉节段805支,其中无狭窄、轻度、中度、重度及闭塞病变依次为539支、48支、146支、66支及6支。CTA检查无狭窄、轻度、中度、重度及闭塞病变依次540支、47支、150支、62支及6支。以CAG为金标准,CTA诊断冠脉动脉狭窄灵敏度为94.36%(251/266)、特异度为97.40%(525/539)、准确率为96.40%(776/805);CTA诊断冠状动脉临界病变灵敏度为91.78%(134/146)、特异度为97.57%(643/659),准确率为96.52%(777/805),一致性分析Kappa值为0.884,提示CTA诊断冠状动脉临界病变一致性较佳。经ROC曲线结果显示AUC值为0.947(95%CI:0.920~0.974)。结论CTA用于冠状动脉临界病变诊断具有较高诊断价值,可作为无介入检查及治疗指征患者筛查手段。

Objective To evaluate the efficacy of coronary CT angiography(CTA) in the diagnosis and evaluation of critical coronary artery plaques.Methods A retrospective study was conducted in 90 patients who underwent CTA and coronary angiography(CAG) examination in our hospital from March 2022 to March 2024.CAG was used as the diagnostic gold standard to analyze the diagnosis and evaluate the efficacy of CTA in plaque with critical coronary artery lesions.Results CAG examination showed 805coronary artery segments in 90 patients,among which 539,48,146,66 and 6 coronary artery segments were found without stenosis,mild,moderate,severe and occlusive lesions.CTA showed no stenosis,mild,moderate,severe and occlusive lesions in 540,47,150,62 and 6 cases,respectively.Using CAG as the gold standard,the sensitivity of CTA in diagnosing coronary artery stenosis was 94.36%(251/266),the specificity was 97.40%(525/539),and the accuracy was 96.40%(776/805).The sensitivity of CTA in the diagnosis of critical coronary artery lesions was 91.78%(134/146),the specificity was 97.57%(643/659),the accuracy was 96.52%(777/805),and the Kappa value of consistency analysis was 0.884,suggesting that CTA had a good consistency in the diagnosis of critical coronary artery lesions.The ROC curve showed that the AUC value was 0.947(95%CI:0.920~0.974).Conclusion CTA has a high diagnostic value in the diagnosis of critical coronary artery disease,and can be used as a screening method for patients without inte rventional exa mination and treatment indications.