CT冠状动脉定量在评估冠心病患者心肌缺血诊断中的应用价值分析

Analysis of the Application Value of Quantitative CT Coronary Angiography in the Diagnosis of Myocardial Ischemia in Patients with Coronary Heart Disease

目的对比分析电子计算机断层扫描(CT)冠状动脉定量在评估冠心病患者心肌缺血诊断中的应用价值。方法将80例疑似冠心病心肌缺血患者设置为研究对象,均在2023年3月至2024年3月期间于阜外华中心血管病医院就诊;纳入研究者入院后均接受CT冠状动脉定量检查,将诊断结果与金标准(心肌灌注成像)检查结果进行对照,计算CT冠状动脉定量在冠心病患者心肌缺血中的诊断效能,同时对比心肌缺血阳性患者、阴性患者CT冠状动脉定量指标,包括斑块形态特征相关指标(餐巾环征、点状钙化、低密度斑块)和其它斑块定量指标[病变长度(PL)、狭窄程度(DS)、斑块负荷(PB)、斑块体积(PV)、钙化积分(CS)、重建指数(RI)]。结果经心肌灌注成像确诊阳性60例,阴性20例,CT冠状动脉定量检查确诊阳性58例、阴性22例,CT冠状动脉定量检查在冠心病心肌缺血中的诊断准确度、敏感度、特异度均为95.00%。心肌缺血阳性患者低密度斑块、餐巾环征、点状钙化检出例数分别为14(24.14%)、16(27.59%)、15(25.86%),心肌缺血阴性患者检出例数分别为3(13.64%)、4(18.18%)、6(27.27%),对比差异无统计学意义(P>0.05);心肌缺血阳性患者PL、CS、PV、PB、DS、RI测值均高于心肌缺血阴性患者,差异均有统计学意义(P<0.05),结论CT冠状动脉定量诊断冠心病患者心肌缺血准确性较高,值得应用。

Objective To compare the application value of quantitative computed tomography(CT)coronary angiography in the diagnosis of myocardial ischemia in patients with coronary heart disease.Methods A total of 80 suspected coronary heart disease myocardial ischemia patients who were treated at Fuwai Central China Cardiovascular Hospital from March 2023 to March 2024 were selected as study subjects.All patients underwent quantitative CT coronary angiography,and the diagnostic results were compared with the gold standard(myocardial perfusion imaging)to calculate the diagnostic efficacy of quantitative CT coronary angiography in myocardial ischemia in coronary heart disease patients.The quantitative CT coronary angiography indicators of myocardial ischemia positive and negative patients plaque morphology indicators(napkin-ring sign,spotty calcification,low-density plaque)and other plaque quantitative indicators[lesion length(PL),degree of stenosis(DS),plaque burden(PB),plaque volume(PV),calcium score(CS),remodeling index(RI)]were compared.Results Myocardial perfusion imaging confirmed 60 positive cases and 20 negative cases.Quantitative CT coronary angiography confirmed 58 positive cases and 22 negative cases,with a diagnostic accuracy,sensitivity,and specificity of 95.00%for myocardial ischemia in coronary heart disease patients.Among myocardial ischemia positive patients,the number of detected low-density plaques,napkin-ring signs,and spotty calcifications were 14(24.14%),16(27.59%),and 15(25.86%),respectively,while in myocardial ischemia negative patients,they were 3(13.64%),4(18.18%),and 6(27.27%),with no statistical significance(P>0.05).The measurements of PL,CS,PV,PB,DS,and RI were significantly higher in myocardial ischemia positive patients compared to negative patients(P<0.05).Conclusion Quantitative CT coronary angiography has high accuracy in diagnosing myocardial ischemia in coronary heart disease patients and is worth applying.