宝石CT冠脉成像对冠心病诊断的临床应用价值  

The Clinical Value of Gemstone spectral CT in angiography of Coronary artery

作　　者：吴爽[1] 薛雁山[1] 许立功[1] 

机构地区：[1]山西医科大学第二医院CT室,太原030001

出　　处：《中国医疗前沿》2012年第5期62-63,59,共3页China Healthcare Innovation

摘　　要：目的评价宝石CT冠状动脉造影(Gemstone Computed Tomography Angiography,GCTA)在诊断冠状动脉狭窄≥50%时的准确性,探讨GCTA在冠心病诊断中的临床应用价值。方法对60例疑诊冠心病患者行GCTA检查,利用其后处理功能对240支冠脉主要分支进行重建和分析。对GCTA诊断有狭窄的患者再行选择性冠状动脉造影(Coronary Angiography,CAG)检查,以CAG结果为金标准,评价其诊断冠状动狭窄≥50%的准确性。结果 60例行GCTA检查的患者均能清晰显示冠脉主干及其分支,其中有20例患者诊断有不同程度的狭窄,并行CAG检查。GCTA结果显示这20例患者的80支冠脉中有32支冠脉诊断为中、重度狭窄;有11支冠脉诊断为轻度狭窄;有37支冠脉诊断为无狭窄。CAG结果显示这20例患者的80支冠脉中有34支冠脉诊断为中、重度狭窄;有10支冠脉诊断为轻度狭窄;有36支冠脉诊断为无狭窄。GCTA评价冠状动脉狭窄≥50%的敏感度、特异度、准确性、阳性预测值、阴性预测值分别为88.23%、95.65%、93.75%、91.67%、92.50%。结论宝石CT冠状动脉造影检查对冠脉疾病诊断的准确率较高,发现斑块位置及判断其易损性是对CAG的补充,其最新的心脏功能分析软件还能够对心功能进行准确分析,故宝石CT冠脉造影可作为冠心病高危人群无创性筛选检查的首选方法。Objective The objective of the current study was to evaluate the accuracy and feasibility of Gemstone Computed Tomography Angiography（GCTA） in detecting coronary artery stenosis.To explore the diagnosis of coronary heart disease and its clinical signification with gemstone computed tomography angiography.Methods GCTA was performed on sixty patients with suspected or proven coronary heart diseases.The coronary angiography（CAG） results were served as ＇gold standard＇ to evaluate the diagnostic accuracy of GCTA in coronary artery significant stenosis.Results The main branches and part of the sub-branches of the coronary artery were clearly showed.43 coronary artery branches of 20 patients were found different degrees of stenosis.In 20 cases with conventional angiography,all patients demonstrated branches of coronary stenosis with hard and soft plaque.Conclusion Gemstone CT has higher accuracy in diagnosis of coronary heart disease.It can find that wall plaque location and determine the vulnerability of the CAG added that can performed as the method of choice of high-risk groups of coronary heart disease non-invasive screening.

关 键 词：宝石CT 冠心病 体层摄影术 冠状动脉造影 

分 类 号：R540.4[医药卫生—心血管疾病]