3D-CCTA对冠状动脉狭窄程度评估的可行性研究  

Feasibility of 3D-CCTA on evaluation of coronary artery stenosis degree

作　　者：弥龙[1] 李小华[1] 王军[1] 姚远[1] 刘旭东[1] 涂蓉[1] 施玉森[1] 

机构地区：[1]海南医学院第一附属医院放射科,海南海口570102

出　　处：《海南医学》2017年第4期603-606,共4页Hainan Medical Journal

基　　金：2014年度海南医学院科研培育基金(编号:HY2014-011)

摘　　要：目的探讨三维影像冠状动脉CT成像(3D-CCTA)对冠状动脉狭窄程度评估的可行性。方法选择我院2013-2015年怀疑或诊断为冠心病的50例患者,年龄35~82岁,体质量指数(BMI)<30㎏/cm2,心率均<80次/min,行3D-CCTA检查,得到VR、MIP、MPR图像。参照美国心脏协会(AHA)的冠状动脉15段分法,对冠状动脉各节段的狭窄情况进行统计,计算3D-CCTA诊断冠状动脉狭窄的敏感度、特异度、阳性预测值及阴性预测值,并比较3D-CCTA与X线冠状动脉造影(CAG)诊断冠状动脉狭窄的一致性。结果 50例患者3D-CCTA检查共有640个可评价节段,其中,150段存在不同程度狭窄,CAG共评价冠状动脉656段,其中,143段有不同程度狭窄,3D-CCTA和CAG诊断冠状动脉狭窄程度相符合者共127段,两者均诊断为正常者共478段。3D-CCTA诊断冠脉狭窄的敏感度、特异度、阳性预测值、阴性预测值各为92.3%、96.3%、88.3%和97.6%,正确率为94.5%。结论 3D-CCTA评估冠状动脉狭窄程度有较大的优势,与CAG一致性较高。Objective To explore the feasibility of the three-dimensional cardiac computed tomography angiog-raphy （3D-CCTA） on evaluation of coronary artery stenosis degree. Methods Fifty patients （aged 35-82 years, bodymass index （BMI） 〈 30 kg/cm2, heart rate 〈80 beats/min） with suspected or diagnosed as coronary heart disease （CHD）in our hospital from 2013 to 2015 were selected. They underwent 3D-CCTA examination, and volume rendering （VR）,maxi-identity projection （MIP） and multi-plain reconstruction （MPR） images were obtained. The stenosis degree of eachsegment of the coronary artery was recorded, according to American Heart Association （AHA） 15-segment model. Thesensitivity, specificity, positive predictive value, and negative predictive value of 3D-CCTA in diagnosis of coronary ar-tery stenosis degree were calculated. The consistency of 3D-CCTA and X-ray coronary angiography （CAG） in the diag-nosis of coronary artery stenosis were compared. Results A total of 640 segments were evaluated with 3D-CCTA in 50patients, with different degrees of stenosis in 150 segments, and 656 segments were evaluated with CAG, with differentdegrees of stenosis in 143 segments, among which 127 were confirmed as stenosis by both 3D-CCTA and CAG and 478segments were confirmed as normal. The sensitivity, specificity, positive predictive value, negative predictive value of3D-CCTA in diagnosis of coronary artery stenosis degree were respectively 92.3%, 96.3%, 88.3% and 97.6%, and the ac-curacy was 94.5%. Conclusion 3D-CCTA has considerable advantages in the assessment of coronary artery stenosisdegree, which has high consistency with the CAG.

关 键 词：冠状动脉粥样硬化性心脏病 冠状动脉 三维影像冠状动脉CT成像 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病]