双源CT冠脉造影诊断准确性的影响因素  

Factors affecting diagnostic accuracy of coronary dual-source computed tomography angiography

作　　者：周逸[1] 陈曼华[1] 戴睿[1] 周炜[1] 郭彩虹 

机构地区：[1]武汉市中心医院心内科,湖北武汉430014

出　　处：《心脏杂志》2017年第6期701-704,共4页Chinese Heart Journal

基　　金：武汉市卫生局临床医学科研项目资助(WX12B03)

摘　　要：目的以选择性冠脉造影(SCA)为标准判断双源CT(dual-source computed tomography,DSCT)冠脉造影的结果,分析影响DSCT冠脉造影诊断准确性的因素。方法回顾性分析DSCT冠脉造影诊断为冠心病,后行选择性冠脉造影的患者156例,共分析1 369个节段,其中751个病变节段。绘制受试者工作特征曲线(ROC),计算曲线下面积(AUC)值。比较病变不同钙化程度、病变血管直径、病变长度和病变血管分布对DSCT冠脉造影诊断准确性的影响。结果重度钙化的AUC值明显低于中度钙化(0.571 vs.0.718,P<0.05)和轻度钙化(0.571 vs.0.843,P<0.01)。血管直径较小病变的AUC值明显低于血管直径较大病变(0.699 vs.0.861,P<0.01)。回旋支病变的AUC值明显低于前降支病变(0.724 vs.0.836,P<0.05)和右冠病变(0.724 vs.0.853,P<0.05)。结论重度钙化、血管直径较小和回旋支病变都是降低DSCT冠脉造影诊断准确性的因素。AIM The present investigation evaluated the results of dual-source computed tomography （DSCT） angiography for coronary stenosis assessment and analyzed the faetors affecting the diagnostic aceuraey of DSCT, using selective coronary angiography （SCA） as a reference standard. METHODS This retrospective analysis enrolled 156 patients diagnosed with coronary artery disease by DSCT angiography and then underwent selective coronary angiography. In total, 751 lesions in 1 369 segments were analyzed. The receiver operation characteristic （ROC） curve and area under curve of ROC （AUC） were used for statistical analysis. The influence of the characteristics of the lesions on the diagnostic performance of DSCT was evaluated. These characteristics of lesions included the extent of calcification, the lesion artery external diameter, the lesion length and the lesion location. RESULTS The AUC of severe calcified lesions was lower than those of moderate calcified lesions and mild calcified lesions （0. 571 vs. O. 718, P 〈0. 05 and 0. 571 vs. O. 843, P 〈0. 01, respectively）. The AUC of lesions with artery external diameter 〈 3 mm was lower than that of lesions with artery external diameter ~〉3 mm （0. 699 vs. O. 861, P 〈 0. 01 ）. The AUC of lesions in the left circumflex was lower than those of lesions in the left anterior descending artery and lesions in the right coronary artery （0. 724 vs. 0. 836, P 〈0. 05 and 0. 724 vs. 0. 853, P 〈0. 05, respectively）. CONCLUSION Severe calcification, lesion artery external diameter 〈 3 mm and lesions in the left circumflex all are factors affecting the DSCT diagnostie accuracy of coronary stenosis.

关 键 词：冠状动脉 体层摄影术 螺旋计算机 血管造影术 

分 类 号：R541.4[医药卫生—心血管疾病]