低辐射量CT冠状动脉造影联合斑块钙化积分对评估冠状动脉狭窄的临床价值  

Clinical Value of Low Radiation CT Coronary Angiography Combined with Plaque Calculus Integral in Evaluating Coronary Artery Stenosis

作　　者：周宏[1] 罗光华[1] 卿伟鹏[1] 谢佩含 杨娟[1] 董雨岚 刘进才[1] 

机构地区：[1]南华大学附属第一医院放射科,湖南衡阳421001

出　　处：《航空航天医学杂志》2017年第6期645-648,共4页Journal of Aerospace medicine

基　　金：衡阳市科学技术发展计划项目应用基础研究计划(2015KJ40);湖南省教育厅科学研究重点项目(14A126)

摘　　要：目的分析低辐射量CT冠状动脉造影(coronary angiography,CTCA)联合斑块钙化积分对评估冠状动脉狭窄的临床价值。方法采取前瞻性研究,选取行低辐射量CTCA检查的75例患者作为研究对象,其中男患占65.33%(49/75),女患占34.67%(26/75),均采取低辐射量CTCA扫描,在低辐射量CTCA图像中评估斑块钙化积分,并以侵入性冠状动脉造影结果为参考标准,综合评估冠状动脉狭窄情况,分为冠状动脉明显狭窄组和冠状动脉无明显狭窄组,对比两组患者的斑块钙化积分,分析低辐射量CTCA、斑块钙化积分及两者联合对冠状动脉狭窄的诊断准确率。结果冠状动脉明显狭窄组的斑块钙化积分503.2±557.4,高于冠状动脉无明显狭窄组的42.6±79.6,差异显著(P=0.002,<0.01);低辐射量CTCA评估冠状动脉狭窄的灵敏度、特异度、诊断符合率分别为96.2%、78.26%、90.67%,斑块钙化积分评估冠状动脉狭窄的灵敏度、特异度、诊断符合率分别为85.19%、100.0%、89.47%,两者联合评估冠状动脉狭窄的灵敏度、特异度、诊断符合率分别为96.15%、100.0%、97.33%。结论在冠状动脉狭窄的评估方法选择上,低辐射量CTCA、斑块钙化积分分别具有很高的敏感度、特异度,两者联合可进一步提高对冠状动脉狭窄的评估准确率,不额外增加辐射剂量、延长扫描时间,值得临床借鉴应用。Objective To analyze the clinical value of low radiation CT coronary angiography （CTCA） combined with plaque calcification in assessing coronary artery stenosis. Methods A prospective study was conducted. 75 patients with low radiation CTCA were selected as the subjects. Among them, 65.33% （49/75） were male and 34.67% （26/ 75 ） were female, and low radiation CTCA scan, in the low radiation CTCA images to assess plaque calcification score, and the results of invasive coronary angiography as a reference standard, comprehensive assessment of coronary artery stenosis, divided into coronary artery stenosis and coronary artery no obvious stenosis group, The calcification score of the two groups was compared, and the diagnostic accuracy of low radiation CTCA, plaque calcification and the combined diagnosis of coronary artery stenosis were analyzed. Results The calcification score of the coronary artery stenosis group was 503.2±557.4, which was significantly higher than that of the coronary artery （42. 6±79. 6 ）, the difference was significant （ P = 0. 002, 〈0. 01 ） ; the low radiation CTCA was used to evaluate the sensitivity of coronary artery stenosis, Specificity and diagnostic coincidence rate were 96. 2%, 78. 26% and 90. 67% respectively. The sensitivity, specificity and diagnostic coincidence rates of coronary artery stenosis were 85.19%, 100. 0% and 89.47% respectively. The sensitivity, specificity and diagnostic accuracy of coronary artery stenosis were 96. 15%, 100. 0% and 97. 33%, respectively. Conclusions In the choice of coronary artery stenosis, low radiation CTCA and plaque calcification scores have high sensitivity and specificity, and the combination of the two can further improve the accuracy of the evaluation of coronary artery stenosis, Radiation dose, extended scan time, worthy of clinical reference.

关 键 词：冠状动脉狭窄 冠状动脉粥样硬化 CT冠状动脉造影 斑块钙化积分 

分 类 号：R816.2[医药卫生—放射医学]