64排VCT冠状动脉成像与冠脉造影对冠心病诊断的对比研究  

Comparative Study of 64-slice VCT Coronary Angiography and Catheter Coronary Angiography in Diagnosing Coronary Artery Disease

作　　者：郭建平[1] 朱杏莉[1] 姚斯元[1] 邢朋毅[1] 黄静[1] 

机构地区：[1]解放军150中心医院CT室,河南洛阳471031

出　　处：《实用放射学杂志》2009年第12期1745-1747,1764,共4页Journal of Practical Radiology

摘　　要：目的探讨64排VCT冠状动脉造影检查对冠状动脉疾病的诊断价值。方法连续性收集173例临床怀疑及确诊冠心病的患者，先后行64排VCT冠状动脉成像（CTA）及冠脉造影（CAG），对所有病例使用GEAW4.3独立工作站提供的冠状动脉分析软件进行分析，主要进行了最大密度投影重建（MIP）、多平面重建（MPR）、容积重建（VR），将获得图像与冠脉造影图像进行对比分析。结果173例中CTA显示的冠状动脉直径〉1.5mm的节段有746个，发现冠状动脉狭窄的敏感性为94.15％（193／204），特异性为95.90％（514／536），阳性预测值为89.77％（193／215），阴性预测值为97.90％（514／525）。配对X^2检验结果说明CTA和CAG2种检查方法在诊断冠状动脉狭窄病变上无统计学差异（X^2=1.58，P〉0.05），CTA与CAG在显示冠状动脉狭窄分级方面的一致性检验（Kappa值=0.890，P〈0.001），提示CTA与CAG在显示与诊断冠状动脉狭窄分级方面具有良好的一致性。结论64排VCT作为冠状动脉疾患的筛选、内支架术后及血管搭桥术后疗效随访有很大的临床应用价值。Objective To evaluate the diagnostic value of 64-row VCT coronary angiography（CTA） in diagnosing coronary artery disease. Methods 64-row VCT coronary angiography（CTA） and cathter coronary angiography（CAG） were performed in 173 patients with suspected coronary artery disease. Ail images were analysed at GE AW4.3 workstation, the constructed images included maximum intensity projection（MIP）, mhi-planar reconstruction（MPR） and volume rendering（VR）. The results were compared with that of CAG. Results 746 segments of coronary artery with diameter 〉1.5 mm were showed by CTA in 173 patients. The sensitivity,specificity,positive predictive value and negative predictive value of the CTA in detecting coronary arterial stenosis were 94.15%（193/203）, 95.90% and 89.77% and 97.90% respectively. Statistical analysis using a 2-related X^2 test showed that there were no obvious differences in diagnosing coronary arterial stenosis between CTA and CAG（X^2= 1.58, P〉0.05） and in evaluating the ste- nosis degree of coronary artery（Kappa=0.890 ,P〈0.001）. Conclusion 64-row VCT has important clinical value in screening coronary arterial disease and in following-up post operational effectiveness of coronary stent implantation and vascular bypass.

关 键 词：冠状动脉造影术 冠心病 体层摄影 x线计算机 

分 类 号：R541.4[医药卫生—心血管疾病] R814.42[医药卫生—内科学]