双源CT冠状动脉造影评价冠状动脉狭窄  

Evaluating coronary artery stenosis with dual-source CT coronary angiography

作　　者：李佩玲[1] 徐克[1] 李延亮[1] 谢秀丽[1] 黎庶[1] 

机构地区：[1]中国医科大学附属第一医院放射科,沈阳辽宁110001

出　　处：《中国医学影像技术》2012年第4期695-699,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家"十一五"科技支撑计划课题项目(2007BAI05B02)

摘　　要：目的评价双源CT(DSCT)冠状动脉造影诊断冠状动脉狭窄的准确性。方法收集104例临床疑诊或确诊冠心病并于30日内先后接受DSCT冠状动脉造影检查和导管法冠状动脉造影(CAG)患者,以CAG诊断结果作为金标准,分别评估DSCT诊断冠状动脉狭窄性病变(<50%、≥50%和≥75%)的价值。结果 CAG显示1296段冠状动脉。DSCT可评估的冠状动脉为1217段,可评估率为93.90%(1217/1296);诊断<50%、≥50%和≥75%狭窄的敏感度分别为79.12%(144/182)、84.73%(172/203)和89.83%(106/118),特异度分别为97.33%(802/824)、99.21%(1006/1014)和99.82%(1097/1099),阳性预测值为86.75%(144/166)、95.56%(172/180)和98.15%(106/108),阴性预测值为95.48%(802/840)、97.01%(1006/1037)和98.92%(1097/1109),准确率为94.04%(946/1006)、96.80%(1178/1217)和98.85%(1203/1217)。钙化斑块是导致血管不可评估及误诊的主要原因。结论 DSCT冠状动脉造影判断冠状动脉狭窄程度的准确性较高,可作为临床筛查冠心病的较为可靠的方法。Objective To explore the value of dual-source CT （DSCT） coronary angiography in the diagnosis of coronary stenosis compared with conventional coronary angiography （CAG）. Methods Totally 104 patients of established or suspected coronary artery disease were collected. All patients consecutively accepted DSCT coronary angiography and CAG within 30 days. The value for detecting stenosis 〈50%, ≥50% and ≥75% were calculated taking CAG as golden standards. Results DSCT could evaluate 1217 segments （1217/1296, 93.90%） in 1296 that showed by CAG. The sensitivity for stenosis 〈50%, ≥50% and ≥75% was 79.12% （144/182）, 84.73% （172/203） and 89.83% （106/118）, respectively, and the specificity was 97.33% （802/824）, 99.21% （1006/1014） and 99.82% （1097/1099）, the positive predictive value was 86.75% （144/166）, 95.56% （172/180） and 98.15% （106/108）, negative predictive value was 95.48% （802/ 840）, 97.01% （1006/1037） and 98.92% （1097/1109）, accuracy was 94.04% （946/1006）, 96.80% （1178/1217） and 98.85% （1203/1217）. Calcified plaque was one of the most important factors causing misdiagnosis of coronary artery segments. Conclusion DSCT coronary angiography has a high accuracy in diagnosis of coronary stenosis. It may be a reliable screening and diagnostic technique in clinic.

关 键 词：体层摄影术 X线计算机 血管造影术 冠状动脉狭窄 

分 类 号：R543.31[医药卫生—心血管疾病] R814.42[医药卫生—内科学]