64层螺旋CT胸痛“三联”CTA技术与诊断价值  

Techniques and diagnostic value of triple-rule-out CTA using 64-MDCT

作　　者：张蕴[1] 荐志洁[1] 赵婷婷[1] 李晨霞[1] 范妤欣[1] 

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西西安710061

出　　处：《中国医学影像技术》2013年第12期2036-2040,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的 探讨64-MDCT胸痛“三联”CTA（TRO CTA）成像技术的图像质量及诊断价值。方法 对56例不典型胸痛患者应用回顾性心电门控技术行冠状动脉CT扫描，扫描长度自胸锁关节平面至心膈面下2 cm。扫描完成后测量4个心腔和22个血管节段的CT值，评估图像质量，并评价TRO CTA的诊断价值。结果 56例中，1177个血管节段（1177/1232，95.54%）CT值〉250 HU，36个（36/1232，2.92%）CT值200~250 HU，19个（19/1232，1.54%）CT值〈200 HU。血管节段图像质量为优937个（937/1232，76.06%），良235个（235/1232，19.07%），一般36个（36/1232，2.92%），差24个（24/1232，1.95%）。TRO CTA诊断的敏感度、特异度、阳性预测值、阴性预测值分别为90.91%（30/33）、98.79%（163/165）、93.75%（30/32）、98.19%（163/166），Youden指数为89.70%，Kappa值为0.908（P〈0.01）。结论 TRO CTA 方便、安全，图像质量能够满足临床诊断要求，具有较高的应用价值。Objective To explore the imaging quality and diagnostic value of triple-rule-out CTA （TRO CTA） using 64-MDCT. Methods Totally 56 patients with atypical chest pain underwent retrospective ECG-gated 64-MDCT coronary CTA. The scan range and the field of view extended from the plane of sternoclavicular joint to 2 cm below heart diaphragm interface. The CT values of 4 chambers of the heart and 22 vascular segments were measured. The diagnostic value of TRO CTA was evaluated. Results The attenuation values were more than 250 HU in 1177 vascular segments （1177/1232, 95.54%）, from 200 HU to 250 HU in 36 （36/1232, 2.92%）, smaller than 200 HU in 19 vascular segments （19/1232, 1.54%）. Image quality was excellent in 937 vascular segments （937/1232, 76.06%）, good in 235 （235/1232, 19.07%）, acceptable in 36 （36/1232, 2.92%）, whereas poor in 24 （24/1232, 1.95%） vascular segments. The sensitivity, specificity, positive predictive value, negative predictive value of TRO CTA was 90.91% （30/33）, 98.79% （163/165）, 93.75% （30/32） and 98.19% （163/166）, respectively, and Youden index was 89.70%, Kappa value was 0.908 （P〈0.01）. Conclusion The techniques of TRO CTA are easy and safe, having satisfactory image quality and high diagnostic value in clinical application.

关 键 词：冠状动脉 肺动脉 主动脉 体层摄影术 X线计算机 血管造影术 

分 类 号：R743.404[医药卫生—神经病学与精神病学]