CT冠状动脉成像与冠状动脉导管造影评估冠状动脉钙化所致狭窄程度的一致性  

Consistency of CT coronary angiography and invasive coronary angiography in the assessment of stenosis caused by coronary artery calcification

作　　者：冉启胜[1] 闫红野[1] 廖春[1] 兰芳[1] 童海鹏[1] 陈金华[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所放射科,重庆400042

出　　处：《中国医学影像技术》2016年第3期445-448,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨CT冠状动脉成像(CTCA)与冠状动脉导管造影(ICA)评估冠状动脉钙化狭窄程度的一致性。方法选取接受CTCA和ICA、且图像无明显伪影的45例冠状动脉钙化狭窄患者;分别测量其病灶处钙化CT值、血管CT值,计算二者的CT比值,即血管钙化CT比值=病灶周围钙化最高CT值/病灶周围血管近端无钙化层面的血管CT值。以所用患者血管钙化CT比值的总平均值为分界值,将病例分为A、B两组。分别比较两组中CTCA与ICA诊断冠状动脉钙化狭窄程度的一致性。结果 45例患者血管钙化CT比值的总平均值为3.04±0.89;A组血管钙化CT比值<3.04,共21例,CTCA与ICA对其狭窄程度评估的吻合率为95.24%(20/21),诊断一致性极好(Kappa=0.82,P<0.05);B组血管钙化CT比值≥3.04,共24例,CTCA与ICA对其狭窄程度评估的吻合率为37.50%(9/24),诊断一致性差(Kappa=0.172,P<0.05)。结论当血管钙化CT比值<3.04时,采用CTCA评估冠状动脉钙化狭窄程度,与ICA的评估结果具有较好的一致性。Objective To explore the consistency of CT coronary angiography（CTCA）and invasive coronary angiography（ICA）in assessment of the stenosis caused by coronary artery calcification.Methods Totally 45 patients with coronary artery calcification were enrolled,who had done both CTCA and ICA without obvious artifacts interference.The CT value of calcification and vessels were measured,respectively,and then the ratio of both was calculated（the highest value of calcification around the lesions/the CT value of vascular without calcified interference level around the lesions）.The average ratio of vascular calcification in all patients as the boundary value,the patients were divided into group A and group B,and the consistency of CTCA and ICA in assessment of the stenosis were compared in two groups,respectively.Results The average ratio of the 45 cases was 3.04±0.89.In group A,there were 21 cases with the vascular calcification CT ratio〈3.04,and the agreement rate between CTCA and ICA to assess the degree of coronary artery stenosis was 95.24%（20/21）,which had a great consistency（Kappa=0.82,P〈0.05）.In group B,there were 24 cases with the CT ratio≥3.04,the agreement rate between CTCA and ICA to assess the degree of coronary artery stenosis was 37.50%（9/24）,which had a poor consistency（Kappa=0.172,P〈0.05）.Conclusion When the CT ratio of vascular calcification less than 3.04,CTCA have a good consistency with ICA in assessment of the stenosis caused by coronary artery calcification.

关 键 词：冠状动脉成像 冠状动脉导管造影 冠状动脉钙化 

分 类 号：R814.42[医药卫生—影像医学与核医学] R541[医药卫生—放射医学]