电子束CT冠状动脉成像同血管造影的对比

Comparison study of coronary artery electron beam computed tomography and coronary angiography

目的 :评价电子束CT(EBCT)冠脉增强扫描对冠状动脉狭窄的诊断意义 .方法 :5 5例患者分别行EBCT增强扫描和冠状动脉血管造影术 (CAG) ,并由两位不知造影结果的医师进行阅片 ,与CAG结果进行对照 .结果 :EBCT判断狭窄的灵敏度是 :左主干 96 % ,左前降支 89% ,左回旋支 71% .右冠 80 % ,对明显狭窄的 5 8支冠脉 (管腔狭窄≥ 5 0 % )有 4 6支判断正确 ,灵敏度 79% ,12 7支无明显病变的冠脉有 114支判断正确 ,特异度是 90 % (P <0 .0 0 1) .结论 :EBCT增强扫描及其三维重建与冠脉血管造影结果具有高度的相关性 .通过经静脉增强造影 ,EBCT可以清楚地显示冠状动脉并判断管腔的狭窄 ,尤其是重度狭窄 .

AMI: To evaluate the application of electron beam computed tomography (EBCT) for the identification of coronary artery stenosis. METHODS: Coronary angio graphy and intravenous contrast material-enhanced electrocardiographically triggered electron-beam CT (EBCT) of the heart were performed in 55 patients. The coronary arteries were assessed by two observers blinded to the result of the angiography. RESULTS: The sensitivity of EBCT in correctly identifying stenosed arteries were: 96% of left main coronary arteries, 89% of left anterior descending arteries, 71% of the left circumflex arteries and 80% of the right coronary arteries. EBCT correctly identified 46 of the 58 cases significantly stenosed arteries (luminal stenosis>50%) with a sensitivity of 79% and correctly identified 114 of the 127 cases of nonobstructed arteries, with a specificity of 90% ( P <0.001). CONCLUSIONS: EBCT results are highly correlated with those of coronary angiography. By using intravenous contrast enhancement, that EBCT can clearly depict the coronary artery anatomy and can identify the coronary artery stenosis, especially severe stenosis.