64层螺旋CT冠状动脉造影对无症状型冠心病的诊断价值  

Diagnostic Values of Coronary Angiography with 64 Slice Spiral CT in Patients with Latent Coronary Heart Disease

作　　者：罗小平[1] 郑春华 范剑峰 

机构地区：[1]江西省南昌市第一医院CT室,330008 [2]心内二科

出　　处：《中国全科医学》2011年第33期3881-3883,共3页Chinese General Practice

基　　金：南昌市科技局-社会发展支撑计划第51号

摘　　要：目的探讨64层螺旋CT冠状动脉造影对无症状型冠心病的诊断价值。方法选取130例临床无症状,但心电图或运动负荷试验阳性,或放射性核素心肌扫描(ECT)检查显示有冠状动脉缺血改变的无症状型冠心病患者,行64层螺旋CT冠状动脉造影和经皮选择性冠状动脉造影。对64层螺旋CT冠状动脉造影显示冠状动脉狭窄和经皮选择性冠状动脉造影显示冠状动脉狭窄的血管进行定量评价。以经皮选择性冠状动脉造影结果作为诊断金标准,计算出64层螺旋CT冠状动脉造影对冠状动脉狭窄的诊断准确性指标。结果 64层螺旋CT冠状动脉造影与经皮选择性冠状动脉造影对冠状动脉狭窄显示的对照结果:灵敏度为54.6%、特异度为95.1%、阳性预测值为77.6%、阴性预测值为87.1%、准确度为85.5%。结论 64层螺旋CT冠状动脉造影是一种无创、简便、经济、安全可靠的筛查冠心病的方法,对无症状型冠心病具有良好的诊断价值,并可对冠状动脉形态学进行良好的评价,从而进行介入治疗的筛选。Objective To evaluate the diagnostic values of 64 slice spiral CT in patients with latent coronary heart disease.Methods A total of 130 patients without clinical symptoms but with abnormal electrocardiogram or exercise load test findings or coronary artery ischemia according to ECT underwent 64 slice spiral CT coronary angiography and conventional percutaneous coronary angiography.Then coronary artery stenosis was quantitatively assessed.We considered the results of percutaneous coronary angiography the gold standard and compared the results of the two different diagnostic methods to determine the accuracy of 64 slice spiral CT.Results Compared with percutaneous coronary angiography,sensitivity,specificity,positive predictive value,negative predictive value and degree of accuracy of 64 slice spiral CT in diagnosing moderate and severe coronary stenosis were 54.6%,95.1%,77.6%,87.1% and 85.5% respectively.Conclusion As a less invasive,simple,economical,safe and reliable method,64 spiral CT coronary angiography has favourable clinical values in diagnosing latent coronary heart disease and provides information about coronary morphology for advanced interventional therapy.However,with limited diagnostic accuracy,this method is still far from replacing the conventional percutaneous coronary angiography at present.

关 键 词：体层摄影术 螺旋计算机 无症状型冠心病 冠状血管造影 诊断 

分 类 号：R541.4[医药卫生—心血管疾病]