冠状动脉CTA在评估冠状动脉-肺动脉瘘瘘口中的应用价值  

The value of CTA in evaluating the fistula orifice of coronary-pulmonary artery fistula

作　　者：闫翠 郭月飞[2] 彭令荣[2] 王陵军[1] 杨忠奇[1] 覃杰[2] 冼绍祥[1] YAN Cui;GUO Yue-fei;PENG Ling-rong;WANG Ling-jun;YANG Zhong-qi;QIN Jie;XIAN Shao-xiang(.Department of Geriatrics,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院老年病科,广东广州510405 [2]中山大学附属第三医院放射科,广东广州510630

出　　处：《广东医学》2018年第24期3621-3624,共4页Guangdong Medical Journal

基　　金：国家自然科学基金资助项目(编号:81673796;81673920);广东省科技计划项目(编号:2015A020212017);广东省自然科学基金资助项目(编号:2016A030313323);广州市创新平台与科技服务专项项目(编号:201705030006)

摘　　要：目的探讨冠状动脉CTA在评估冠状动脉-肺动脉瘘(CPF)瘘口中的价值。方法收集38 322例行冠状动脉CT成像(CTA)患者,发现CPF 186例,其中45例行冠状动脉造影(CAG)确诊为CPF。在1 mm层厚层距CT轴位及冠状位纵隔窗上观察45例CPF瘘口。计算CTA发现CPF瘘口的敏感度、特异度、阳性预测价值及阴性预测价值,对比CTA与CAG测量瘘口直径大小。结果在45例CPF中,CAG发现瘘口51个,其中39例有1个瘘口,6例有2个瘘口。CT发现瘘口50个,其中40例有1个瘘口,5例有2个瘘口。CT误诊瘘口1个,漏诊瘘口2个。CT发现瘘口的敏感度、特异度、阳性预测价值及阴性预测价值分别为95. 33%、93. 46%、91. 22%、94. 78%。45例CPF中最大瘘口直径的CT测量值与CAG测量值为5. 34、5. 46mm,最小瘘口直径的CT测量值与CAG测量值为1. 0、0. 80 mm。45例CPF瘘口直径的CT和CAG测量平均值分别为(2. 16±0. 88) mm和(2. 08±0. 94) mm,差异无统计学意义(t=0. 808,P=0. 402)。结论冠状动脉CT是发现CPF瘘口和测量瘘口大小的可靠无创性检查方法。Objective To evaluate the value of CTA in evaluating the fistula orifice of coronary-pulmonary artery fistula( CPF). Methods Coronary CT angiography( CCTA) was performed in 38 322 patients. Forty-five out of38 322 patients were diagnosed with CPF confirmed by conventional coronary angiography( CAG). The sensitivity,specificity,positive predictive value and negative predictive value of CT in detecting CPF fistula were calculated. The fistula diameter measured by CT was compared with that measured by CAG. Results Fifty-one fistulas were found in 45 cases of CPF by CAG. There were 1 fistula in 39 cases and 2 fistulas in 6 cases by CAG. Fifty fistulas were revealed by CT. There were 1 fistula in 40 cases and 2 fistulas in 5 cases by CT. Three fistulas were misdiagnosed by CT. The sensitivity,specificity,positive predictive value and negative predictive value of CT were 95. 33%,93. 46%,91. 22% and 94. 78%,respectively. In 45 cases of CPF,the maximum fistula diameter measured by CT and CAG were 5. 34 mm and 5. 46 mm,respectively; and the minimum fistula diameter measured by CT and CAG were 1. 0 mm and 0. 80 mm,respectively. The fistula diameter measured by CT and CAG were( 2. 16 ± 0. 88) mm and( 2. 08 ± 0. 94) mm,respectively,in 45 cases of CPF. There was no significant difference between the fistula diameters measured by CT and CAG( t = 0. 808,P =0. 402). Conclusion Coronary CTA is a reliable and noninvasive method in detecting CPF fistula and measuring fistula diameter.

关 键 词：冠状动脉-肺动脉瘘 断层摄影术 X线计算机 血管造影术 

分 类 号：R816.2[医药卫生—放射医学] R543[医药卫生—临床医学]