目的:探究SOMATOM Force 双源CT冠状动脉造影(DSCTCA)对冠心病患者冠状动脉狭窄的诊断价值。方法:选取2017年1月—2019年12月期间收治的疑似冠心病患者80例,均接受DSCTCA、CAG(冠状动脉造影)诊断,以CAG诊断结构为金标准,评价DSCTA的诊...目的:探究SOMATOM Force 双源CT冠状动脉造影(DSCTCA)对冠心病患者冠状动脉狭窄的诊断价值。方法:选取2017年1月—2019年12月期间收治的疑似冠心病患者80例,均接受DSCTCA、CAG(冠状动脉造影)诊断,以CAG诊断结构为金标准,评价DSCTA的诊断价值。结果:共计312支冠状动脉,其中CAG诊断:无狭窄、轻度狭窄、中度狭窄、重度狭窄分别为147支、75支、56支、34支。DSCTCA诊断显示的支数分别为148、76、56、32支。两种诊断方式下冠脉狭窄程度情况对比,无显著差异(P>0.05)。其中CAG诊断:中重度狭窄90支、轻度狭窄或无狭窄222支。DSCTCA诊断:中重度狭窄88支,轻度狭窄224支。两种诊断方式下中重度狭窄情况比较,无显著差异(P>0.05)。DSCTCA诊断的敏感度为94.44%(85/90),特异度为98.65%(219/222),准确度为96.59%(85/88)。SAP(稳定型心绞痛)患者粥样硬化斑块的CT值(86.49±20.15)Hu;ACS(急性冠状动脉综合征)患者粥样硬化斑块的CT值(421.53±106.74)Hu,组间对比,差异显著(t=13.126,P=0.000)。结论:应用SOMATOM Force双源CT冠状动脉造影检查冠心病,其敏感度、特异度、准确度与CAG相当,二者在中重度冠状动脉狭窄诊断上一致性较高,值得临床推广应用。展开更多
Objective To investigate the performance of dual-source computed tomography （DSCT） using high-pitch spiral fliPS） mode for coronary stents patency. Methods We conducted a prospective study on 120 patients with 260 ...Objective To investigate the performance of dual-source computed tomography （DSCT） using high-pitch spiral fliPS） mode for coronary stents patency. Methods We conducted a prospective study on 120 patients with 260 previous stents implanted due to recurred suspicious symptoms of angina scheduled for invasive coronary angiography （ICA）, while DSCT were conducted using HPS mode. Results There was no significant impact of age, body mass index or heat rate （HR） on image quality （P 〉 0.05）, while HR variability had a slight impact on that （P 〈 0.05）. Sensitivity, specificity, positive predictive value （PPV）, negative predictive value （NPV） of DSCT in detection of in-stent restenosis （ISR） based per-patient were 92.3%, 96.7%, 88.9%, and 97.8%, respectively. And those based per-stent were 87%, 96.8%, 83.3%, and 97.7% with un-assessment stents, 97.4%, 99.5%, 97.4%, and 99.5% without un-assessment stents. There was significant differ- ence on sensitivity, specificity, PPV and NPV between diameter 〉 3.0 mm group （93.3%, 97.9%, 87.5%, and 98.9%） and diameter 〈 3.0 mm group （80%, 93.3%, 80.0%, and 93.3%） （P 〈 0.05）, and that between stent number 〉 3 group （82.3%, 77.8%, 66.7%, and 60%） with 〈 3 group （97.3%, 80%, 96.5%, and 75%）. The effective dose of DSCT （1.4 ± 0.5 mSv） is significantly less than that by invasive coronary angiography [4.0 ± 0.8 mSv （P 〈 0.01）]. Conclusion DSCT using HPS mode provides good diagnostic performance on stent patency with lower effective dose in patients with HR 〈 65 beats/rain.展开更多
文摘目的:探究SOMATOM Force 双源CT冠状动脉造影(DSCTCA)对冠心病患者冠状动脉狭窄的诊断价值。方法:选取2017年1月—2019年12月期间收治的疑似冠心病患者80例,均接受DSCTCA、CAG(冠状动脉造影)诊断,以CAG诊断结构为金标准,评价DSCTA的诊断价值。结果:共计312支冠状动脉,其中CAG诊断:无狭窄、轻度狭窄、中度狭窄、重度狭窄分别为147支、75支、56支、34支。DSCTCA诊断显示的支数分别为148、76、56、32支。两种诊断方式下冠脉狭窄程度情况对比,无显著差异(P>0.05)。其中CAG诊断:中重度狭窄90支、轻度狭窄或无狭窄222支。DSCTCA诊断:中重度狭窄88支,轻度狭窄224支。两种诊断方式下中重度狭窄情况比较,无显著差异(P>0.05)。DSCTCA诊断的敏感度为94.44%(85/90),特异度为98.65%(219/222),准确度为96.59%(85/88)。SAP(稳定型心绞痛)患者粥样硬化斑块的CT值(86.49±20.15)Hu;ACS(急性冠状动脉综合征)患者粥样硬化斑块的CT值(421.53±106.74)Hu,组间对比,差异显著(t=13.126,P=0.000)。结论:应用SOMATOM Force双源CT冠状动脉造影检查冠心病,其敏感度、特异度、准确度与CAG相当,二者在中重度冠状动脉狭窄诊断上一致性较高,值得临床推广应用。
文摘Objective To investigate the performance of dual-source computed tomography （DSCT） using high-pitch spiral fliPS） mode for coronary stents patency. Methods We conducted a prospective study on 120 patients with 260 previous stents implanted due to recurred suspicious symptoms of angina scheduled for invasive coronary angiography （ICA）, while DSCT were conducted using HPS mode. Results There was no significant impact of age, body mass index or heat rate （HR） on image quality （P 〉 0.05）, while HR variability had a slight impact on that （P 〈 0.05）. Sensitivity, specificity, positive predictive value （PPV）, negative predictive value （NPV） of DSCT in detection of in-stent restenosis （ISR） based per-patient were 92.3%, 96.7%, 88.9%, and 97.8%, respectively. And those based per-stent were 87%, 96.8%, 83.3%, and 97.7% with un-assessment stents, 97.4%, 99.5%, 97.4%, and 99.5% without un-assessment stents. There was significant differ- ence on sensitivity, specificity, PPV and NPV between diameter 〉 3.0 mm group （93.3%, 97.9%, 87.5%, and 98.9%） and diameter 〈 3.0 mm group （80%, 93.3%, 80.0%, and 93.3%） （P 〈 0.05）, and that between stent number 〉 3 group （82.3%, 77.8%, 66.7%, and 60%） with 〈 3 group （97.3%, 80%, 96.5%, and 75%）. The effective dose of DSCT （1.4 ± 0.5 mSv） is significantly less than that by invasive coronary angiography [4.0 ± 0.8 mSv （P 〈 0.01）]. Conclusion DSCT using HPS mode provides good diagnostic performance on stent patency with lower effective dose in patients with HR 〈 65 beats/rain.
