GE 660CT在冠状动脉CTA诊断冠状动脉病变中的临床应用价值分析

Clinical application value of GE660CT coronary CTA in diagnosis of coronary artery disease

目的探讨GE 660CT在冠状动脉CTA诊断冠状动脉病变中的临床应用价值。方法选取2017年5月—2018年5月本院收治的冠心病患者120例作为研究对象,所有患者皆行GE 660CT冠脉CTA与经皮冠状动脉造影(CAG)检查。对比两种检查方式的诊断准确性,并计算GE 660CT冠脉CTA在冠心病诊断中的效能。结果 CAG检查结果显示,有4例前降支近端呈完全闭塞,亦有2例回旋支近端呈完全闭塞,将这6例排除,因而对1430个节段皆行分析,正常节段数为1194个,轻度、中度、重度节段分别为26、112、98个; GE 660CT冠脉CTA检查结果显示,正常节段数为1204例,轻度、中度、重度节段分别为42,114,70例;将两种检查方法进行对比,GE 660CT冠脉CTA检查中有92.9%(1328/1430)的节段与CAG结果一致。另有1.8%(26/1430)的节段判断狭窄程度偏高,而5.3%(76/1430)的节段判断狭窄程度偏低。随后以CAG结果为金标准,判断GE 660CT冠脉CTA诊断效能,诊断灵敏度、特异度、阳性预测值、阴性预测值分别为79.1%,98.5%,90.2%,96.5%。结论 GE 660CT冠脉CTA在冠心病诊断中,其诊断特异度、阳性预测值以及阴性预测值皆在90%以上,其灵敏度略低,因而可以作为诊断或排除冠心病的检查手段,同时GE 660CT冠脉CTA是一种无创手段,因此在临床上可进一步推广应用。

Objective To explore the clinical application value of GE 660 CT coronary CTA in diagnosis of coronary heart disease( CHD). Methods 120 cases of patients suffered from coronary heart disease admitted to our hospital from May 2017 to May 2018 were selected as study objects. All the patients received GE 660 CT coronary CTA and percutaneous coronary angiography( CAG) examination. The diagnostic accuracy of the two examination methods was compared and the efficacy of GE 660 CT coronary CTA in the diagnosis of CHD was calculated. Results The results of CAG examination showed that there were 4 cases with complete occlusion on the proximal end of anterior descending branch and 2 cases with complete occlusion on the proximal end of circumflex branch,and these 5 cases were excluded. Therefore,analysis was performed on 1430 segments,results showed that the number of normal segments was 1194,and the number of mild,moderate and severe segments was26,112 and 98,respectively. The results of GE 660 CT coronary CTA examination showed that the number of normal segments was 1204,and the number of mild,moderate and severe segments was 42,114 and 70,respectively. Comparing the two inspection methods,92. 9%( 1328/1430) of the sections in the coronary CTA examination of GE 660 CT were consistent with the results of CAG.Another 1.8%( 26/1430) of the segments were judged to have a high degree of stenosis,while 5.3%( 76/1430) of the segments were judged to have a low degree of stenosis.Subsequently,CAG results were used as the gold standard to determine the diagnostic efficacy of CT coronary CTA in GE 660 CT.The diagnostic sensitivity,specificity,positive predictive value and negative predictive value were 79.1%,98.5%,90.2% and 96.5%,respectively. Conclusions In the diagnosis of coronary heart disease,the specificity,positive predictive value and negative predictive value of GE 660 CT coronary CTA are all above 90%,and its sensitivity is slightly low,so it could be used as a means to diagnose or exclude coronary heart disease. Meanwhile,GE 660 CT coronary CTA is a non-invasive method,so it could be further promoted and applied in clinical practice.