64排螺旋CT血管造影和冠状动脉造影诊断冠心病的临床比较  

Comparative study between 64-slice spiral CTA and coronary arteriongraphy in diagnosis of coronary heart disease

作　　者：卢刚[1] 吕方方[2] 张泉[1] 陈新沛[3] 

机构地区：[1]武警后勤学院附属医院影像科,天津300162 [2]武警后勤学院附属医院呼吸与重症医学科,天津300162 [3]徐州市第一人民医院影像科,江苏徐州221002

出　　处：《医疗卫生装备》2015年第3期76-78,91,共4页Chinese Medical Equipment Journal

摘　　要：目的 ：对比分析CT血管成像（computed tomography angiography,CTA）与数字减影血管造影（digital subtraction angiography,DSA）成像,探讨64排螺旋CT冠状动脉成像技术在冠心病临床诊断中的价值。方法 ：随机选取32例疑似或确诊为冠心病的住院患者,进行CTA及DSA检查（CTA检查均在DSA前1周内完成）,对结果进行对比分析。结果：共分析了32例患者的全部血管节段（243个）,DSA检测到病变节段138处,无病变节段105处,CTA检测到病变节段129处,无病变节段114处;CTA诊断冠状动脉狭窄的敏感性为91.3%,特异性为97.1%,阳性预测值为97.7%,阴性预测值为89.5%,准确率为93.8%;CTA检查发现59支冠状动脉血管有斑块,DSA检查发现62支有斑块,二者之间比较无显著性差异;CTA与DSA对狭窄程度〈50%、50%~75%、〉75%的所有部位病变的检出数目分别为18、24处,35、32处,6、6处,二者比较均无显著性差异。结论 ：64排螺旋CT冠状动脉成像技术对冠状动脉狭窄的诊断较为准确,是诊断冠心病和评价冠状动脉狭窄的一种有效的无创性检查方法。Objective To compare difference of computed tomography angiography（CTA） and digital subtraction angiography（DSA）, and explore the diagnostic value of 64-slice spiral CT coronary artery imaging technique for coronary heart disease. Methods Thirty-two patients with suspected or confirmed coronary heart disease underwent CTA and DSA examinations were collected, comparison and analysis of the coronary angiography results were carried out. Results A total of32 patients with all vascular segments（243）, 138 lesions segments were detected by DSA and the number of negative results was 105, 129 lesions were detected by CTA, and the number of negative results was 114. The sensitivity, specificity,positive predictive value, negative predictive value and accuracy rate of the CTA on diagnosis of coronary artery stenosis were 91.3%, 97.1%, 97.7%, 89.5% and 93.8%, respectively. Fifty-nine coronary artery plaques were found in the CTA findings and 62 plaques were found in DSA examination, and there was no significant difference between the CTA and DSA. The vascular numbers with the degree of stenosis 50%, 50%-75%, 75% were 18 and 24, 35 and 32, 6 and 6 in CTA and DSA, respectively. Conclusion 64-slice spiral CT coronary artery imaging technology is a non-invasive method in the diagnosis of coronary artery stenosis and is accurate to evaluate the coronary artery stenosis.

关 键 词：64排螺旋CT 冠状动脉造影 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]