电子束CT血管造影评价冠状动脉狭窄

Coronary Artery Stenoses:Three-Dimensional Imaging with Contrast Enhanced Electron Beam Computed Tomography

目的 :探讨电子束CT(EBT)血管造影评价冠状动脉狭窄的价值。材料和方法 :分析 5 6例经EBT血管造影和常规冠状动脉造影 (CAG)检查的资料 ,将冠状动脉各支分成 13个节段与相应CAG结果逐一对照 ,并进行统计学分析。结果 :679个≥ 2mm的冠状动脉节段中 ,EBT可评价 5 62个 ,无法评价 117个。EBT对各支冠状动脉的评价准确性依次为左主干、前降支和右冠 ;对各节段的评价以近段的敏感性、特异性和阴性预测值最高 ;对不同程度狭窄的评价以 >75 %狭窄的诊断最为可靠。此外对正常冠状动脉的诊断准确性也较高 ,为 88.5 %。结论 :EBT血管造影对评价冠状动脉近段狭窄、重度狭窄和正常血管有很高的价值 ,可作为CAG术前筛选的常规无创性检查方法。

Purpose: To estimate the values of electron beam tomographic angiography in detecting stenosis of coronary artery. Materials and Methods: Both electron beam tomographic angiography and conventional coronary angiography were carried out in 56 patients with suspected coronary artery disease. A retrospective study were performed and all data were statistically analysed. Results: In all of 679 coronary artery segments with diameter>or=2mm in coronary angiography,562 were assessable and 117 were noninterpretable by the electron beam tomography. The diagnostic accuracy was high in left main coronary artery, anterior descending coronary artery and right coronary artery. Electron beam tomography had higher Sensitivity, specificity and negative predictive value for assessing proximal coronary artery segments stenosis than other coronary portions. The sensitivity, specificity and negative predictive value to detect >75% diameter stenoses were most high.The accuracy of electron beam tomography in detecting normal coronary artery was good with a percentage of 88.5%. Conclusion: Electron beam tomographic coronary angiography has good values for assessing proximal coronary segments stenosis and significant coronary artery stenosis as well as normal coronary arteries. EBT can become a convensional screening examination pre-CAG operation.