64排螺旋CT血管成像对2型糖尿病并冠心病的诊断价值  

The Value of 64-slice Spiral Computed Tomography Angiography for the Assessment of Coronary Artery Disease with Type 2 Diabetes Mellitus

作　　者：李勇[1] 蒋玲君[2] 赖晓阳[3] 

机构地区：[1]广州市花都区人民医院内分泌科,广州510800 [2]广州市花都区人民医院急诊科,广州510800 [3]南昌大学第二附属医院内分泌科,南昌330006

出　　处：《江西医学院学报》2008年第5期82-85,共4页Acta Academiae Medicinae Jiangxi

摘　　要：目的探讨64排螺旋CT血管成像(CTA)对2型糖尿病(T2DM)并冠心病(CAD)的冠状动脉病变的诊断价值。方法收集32例T2DM并CAD患者选择性冠状动脉造影(CAG)和CTA的影像资料,以CAG为金标准,以节段血管为评价单位,评估CTA诊断T2DM并CAD冠状动脉病变的准确性。结果CTA对T2DM并CAD患者冠状动脉病变的诊断敏感性为92.56%,特异性为93.56%,阳性预测值为82.96%,阴性预测值为97.38%,准确率为93.31%,能良好地反应T2DM并CAD患者冠状动脉病变的特点。T2DM并CAD患者冠状动脉钙化较严重,人均受累9.25个节段。随着钙化积分的增高,特异性在下降,但最低也达到87.39%,并且保持了良好的敏感性和阳性预测值。结论CTA是诊断T2DM并CAD冠状动脉病变较可靠、无创的检查方法。T2DM并CAD冠状动脉钙化广泛而严重,钙化对CTA结果判断的影响较小。Objective To evaluate the value of 64-slice spiral computed tomography angiography（CTA） for the assessment of coronary artery disease with type 2 diabetes mellitus. Methods Both CTA imaging and conventional coronary angiography（CAG） imaging were collected in 32 patients who were having coronary artery disease with type 2 diabetes mellitus. Using CAG for the gold standard to assess the CTA in T2DM with CAD in the accuracy of coronary artery stenosis. Results Sensitivity, specificity, positive and negative predictive values and accuracy rating of CTA for detecting significant stenosis on a segment-by-segment analysis were 92.56%, 93.56%, 82.96%, 97.38%, 93.31%, respectively. CTA was able to response accurately to the characteristics of coronary artery disease on T2DM with CAD. The coronary artery calcification was seriously, and the per capita involvement 9.25 segments. With the increase of calcification, specificity on the decline, but had also reached.the end of the 87.39N, and to maintain a good sensitivityand positive predictive value. Conclusion The 64-slice spiral computed tomography angiography in the diagnosis of coronary artery disease is a reliable, non-invasive screening method on T2DM with CAD. The coronary calcification is extensive and serious. The results of coronary disease judged by CTA is less affected by calcification.

关 键 词：2型糖尿病 冠心病 64排螺旋CT血管成像 钙化斑块 选择性冠状动脉造影 

分 类 号：R445.3[医药卫生—影像医学与核医学] R587.1[医药卫生—诊断学]