中危人群双源CT冠脉显像检测冠状动脉狭窄的可靠性  

Dual-Source CT Coronary Angiography in Patients with Intermediate Risk for Coronary Artery Disease

作　　者：王汝[1] 钟萍[1] 周晓芳[1] 卢青[1] 金静[1] 王文艳[1] 

机构地区：[1]四川省人民医院干部医疗科,四川成都610072

出　　处：《中华高血压杂志》2010年第3期235-238,共4页Chinese Journal of Hypertension

摘　　要：目的探讨冠状动脉(冠脉)双源CT(DSCT)评价冠状动脉性心脏病(冠心病)中危人群冠脉狭窄的准确性。方法选择2006-07-2009-05至我院行冠状动脉造影(冠脉造影)的冠心病中危患者67例,男42例,女25例,分别给予双源CT和冠脉造影检查(不予心率控制)。双盲法对图像资料结果进行比较分析。结果66例获得了清晰的图像。在至少有一处狭窄>50%的患者16例中,15例由双源CT准确发现,敏感性93.8%。在无狭窄>50%的患者50例中,45例由双源CT准确排除,特异性90.0%。双源CT诊断冠脉狭窄≥50%的敏感性为94.3%,特异性98.8%,阳性预测值75.0%,阴性预测值99.8%;诊断冠脉狭窄≥75%的敏感性为94.1%,特异性99.4%,阳性预测值76.2%,阴性预测值99.9%。kappa一致性分析发现双源CT与冠脉造影的结果有较好的一致性(κ=0.79,P<0.01)。结论双源CT判断冠心病中危人群冠脉狭窄情况的敏感性及特异性均较高,可作为此人群筛查的安全、可靠方法。Objective To assess diagnostic accuracy and value of dual X-ray source CT（DSCT） in patients with intermediate risk for coronary heart disease（CHD）.Methods DSCT angiography was performed in 67 patients with intermediate risk for CHD who were referred for invasive coronary angiography.Results Of 67 patients,DSCT generated data sets with satisfied quality of diagnostic image in 66.In 16 patients with at least one stenosis 50%,15 were correctly identified by DSCT-angiography（sensitivity 93.8%）.In 45 of 50 patients,a lesion 50% was correctly excluded（specificity 90.0%）.The sensitivity,specificity,positive predictive value and negative predictive value of DSCT were 94.3%,98.8%,75.0% and 99.8% respectively for diagonsing stenosis ≥50% and those were 94.1%,99.4%,76.2% and 99.9% for diagonsing stenosis ≥75%.DSCT-derived stenosis quantification was closely related to quantitative coronary angiography by kappa analysis（κ=0.79,P0.01）.Conclusion Non-invasive DSCT is valid to exclude coronary stenosis in patients with an intermediate risk for CHD.

关 键 词：冠状动脉双源CT 冠状动脉性心脏病 中危 敏感性 特异性 

分 类 号：R816.2[医药卫生—放射医学]