双源CT冠状动脉成像评价冠状动脉狭窄  

Assessment of coronary artery stenosis with dual-source CT angiography

作　　者：张艳艳[1] 冯博[1] 李佩玲[1] 谢秀丽[1] 任玲[1] 

机构地区：[1]中国医科大学附属第一医院放射科,辽宁沈阳110001

出　　处：《中国医学影像技术》2011年第8期1587-1590,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的评价双源CT冠状动脉成像（DSCTA）诊断冠状动脉狭窄的价值。方法回顾性分析41例临床疑似冠心病或已经确诊的冠心病患者的DSCTA和CAG检查资料。以CAG结果为金标准,计算DSCTA诊断轻度（管腔狭窄〈50%）、中度（管腔狭窄50%~75%）、重度（管腔狭窄≥75%）冠状动脉狭窄及DSCTA诊断冠状动脉狭窄的总体敏感度、特异度、阳性预测值、阴性预测值及准确率。结果 41例患者共546个直径≥1.5 mm的冠状动脉节段中535个满足诊断要求,其余11个因钙化斑块遮蔽管腔而无法诊断。DSCTA诊断轻度、中度、重度冠状动脉狭窄敏感度、特异度、阳性预测值、阴性预测值及准确率分别为69.23%（36/52）、96.60%（341/353）、75.00%（36/48）、95.52%（341/357）、93.09%（377/405）,68.42%（26/38）、99.42%（341/343）、92.86%（26/28）、96.60%（341/353）、96.33%（367/381）,70.67%（53/75）、99.71%（341/342）、98.15%（53/54）、93.94%（341/363）、94.48%（394/417）,诊断冠状动脉狭窄的总体敏感度、特异度、阳性预测值、阴性预测值及准确率分别为64.61%（115/178）、95.52%（341/357）、87.79%（115/131）、84.41%（341/404）、85.23%（456/535）。结论作为一种无创性检查手段,DSCTA对评价冠状动脉狭窄程度具有较高的准确性。Objective To observe the value of dual-source CT angiography（DSCTA） in assessing coronary artery stenosis.Methods DSCTA and CAG data of 41 patients with suspected or definitely diagnosed coronary heart disease were retrospectively analyzed.Taking CAG results as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy in diagnosing mild grade stenosis（stenosis of lumen 50%）,medium grade stenosis（lumen stenosis 50%-75%）,severe grade stenosis（stenosis of lumen ≥75%） as well as the above indices of general stenosis were calculated.Results Among the 546 coronary artery segments（the diameter ≥1.5 mm） of 41 cases,535 segments were satisfied with diagnostic requirements,while the other 11 segments were impossible to assess because of the calcified plaques masking the artery vessel.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of DSCTA for mild grade stenosis was 69.23%（36/52）,96.60%（341/353）,75.00%（36/48）,95.52%（341/357） and 93.09%（377/405）,for medium grade stenosis was 68.42%（26/38）,99.42%（341/343）,92.86%（26/28）,96.60%（341/353） and 96.33%（367/381）,for severe grade stenosis was 70.67%（53/75）,99.71%（341/342）,98.15%（53/54）,93.94%（341/363） and 94.48%（394/417）,while for the general stenosis was 64.61%（115/178）,95.52%（341/357）,87.79%（115/131）,84.41%（341/404） and 85.23%（456/535）,respectively.Conclusion As a noninvasive method of inspection,DSCTA can provide high accuracy in detecting coronary artery stenosis.

关 键 词：冠状动脉疾病 狭窄 体层摄影术 X线计算机 冠状血管造影术 

分 类 号：R814.42[医药卫生—影像医学与核医学] R541.4[医药卫生—放射医学]