64层螺旋CT对冠状动脉疾病诊断价值的回顾性分析  

To retrospective analyze the value of 64 multi-slice spiral CT coronary angiography in diagnosis of coronary stenoses

作　　者：黄俊[1] 程涛[2] 

机构地区：[1]安庆海军安庆医院CT,MRI室,246003 [2]安徽医科大学附属省立医院,合肥230001

出　　处：《安徽医学》2011年第4期514-517,共4页Anhui Medical Journal

摘　　要：目的评价64层螺旋CT(MSCT)血管造影在临床冠脉病变诊断中的价值,以及动脉狭窄斑块的性质与狭窄程度的关系。方法回顾性研究58例行64层MSCT检查并行冠状动脉造影(CAG)检查的疑似冠心病或临床诊断冠心病的患者。以CAG结果为金标准,评价64层MSCT检查对冠脉狭窄诊断的灵敏度(Se)、特异度(Sp)、阳性预测值(PPV)、阴性预测值(NPV),以及动脉狭窄斑块的性质与狭窄程度的关系。结果 64层MSCT诊断冠脉节段≥50%狭窄分布与CAG差异无统计学意义(P>0.05)。64层MSCT诊断冠脉血管节段或主要分支≥50%的Se、Sp、PPV、NPV及准确率分别为81.9%、97.8%、80%、98.1%、96.3%或85.9%、94.4%、87.1%、93.8%、91.8%。而以患者为单位计算的Se、Sp为86.7%、82.1%。钙化斑块与非钙化斑块组、钙化斑块与混合斑块组所致狭窄程度分布差异有统计学意义(P≤0.05);而非钙化组与混合斑块组所致冠脉狭窄程度的分布差异无统计学意义(P>O.05)。结论 64层MSCT对冠脉狭窄≥50%的诊断有较高的特异度、阴性预测值及准确率;单纯钙化斑块常致冠脉狭窄程度较轻;混合斑块所致狭窄程度常较严重;非钙化斑块在狭窄程度的分布上无明显特异性。Objective To study the value of 64 MSCT coronary angiography in diagnosis of coronary stenoses（≥50%）in patients with coronary heart disease（CHD）,Compared with conventional angiography（CAG）,and to evaluate the correlation of the plaque and the stenoses.Methods 58 cases with both 64 MSCT scan and CAG exam for coronary angiography were retrospective analyzed.To evaluate the coronary arterial segments or branches Se,Sp,PPV,NPV and accuracy in diagnosis of coronary stenoses（≥50%） and to evaluate the correlation of the plaque and the stenoses.Results The diagnosis value of coronary arterial segments or branches on 64 CTA had little difference,and the Se,Sp,PPV,NPV and accuracy were 81.9%、97.8%、80%、98.1%、96.3% or 85.9%、94.4%、87.1%、93.8%、91.8% respectively.The different stenosed extent resulted from the different coronary plaque（χ2=29.016,P=O.000）.Calcified plaque always scaused mild lumen diameter stenoses.However,the mixed plaque alway leaded to serious lumen diameter stenoses.The distribution of stenoses caused by noncalcified plaque was no specificity,and had a same appearance on CAG.The distribution of stenoses between calcified and noncalcified plaque or between calcified and mixed plaque had significant difference（P=0.000）.Conclusion 64 MSCT has a higher specificity and accuracy in diagnosis of CHD and can be acted as effective screening method.Calcified plaque always caused mild lumen diameter stenoses.However,the mixed plaque always leaded to serious lumen diameter stenoses.The distribution of stenoses caused by noncalcified plaque was no specificity.

关 键 词：64层螺旋CT 冠状动脉造影 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]