多层螺旋CT血管造影在冠状动脉病变程度诊断中的临床价值  

Clinical value of multi-slice spiral CT angiography in the diagnosis of coronary artery lesions

作　　者：崔楚坤 李家欢 曾鹏程[1] 汪剑晖[1] 杨金生[1] 郭嘉亮 CUI Chu-kun;LI Jia-huan;ZENG Peng-cheng;WANG Jian-hui;YANG Jin-sheng;GUO Jia-liang(Radiology Department , Gaoming District People's Hospital of Foshan, Foshan 528500, Guangdong, CHINA;General Department,Gaoming District People’s Hospital of Foshan, Foshan 528500, Guangdong, CHINA)

机构地区：[1]佛山市高明区人民医院放射科,广东佛山528500 [2]佛山市高明区人民医院综合科,广东佛山528500

出　　处：《海南医学》2019年第7期875-877,共3页Hainan Medical Journal

摘　　要：目的探讨多层螺旋CT(MSCT)对病变程度超过50%的冠状动脉的诊断准确性。方法选取2016年1月至2018年2月佛山市高明区人民医院78例冠心病患者共702个冠状动脉节段,分析图像质量及其影响因素,并利用冠状动脉造影作为对照,对比观察MSCT的诊断准确性。结果①702个动脉节段共获得优秀图像质量共604个,占86.04%;图像质量良20个,占2.85%;尚可38个,占5.41%;差38个,占5.41%,此外有2个节段无法观察,占0.28%。可评价节段624个,占88.89%,不可评价节段78个,占11.11%。②影响图像质量因素主要为心率相关因素共45个,占57.69%,其次为屏气不理想,占25.64%。③以冠脉造影为金标准,MSCT诊断灵敏度为74.26%,特异性为96.93%,一致率为93.11%,阳性预测值为82.42%,阴性预测值为95.11%。结论 MSCT诊断冠状动脉血管病变的准确性高,可以对病变程度超过50%冠状动脉做出明确诊断。Objective To investigate the diagnostic accuracy of multi-slice spiral CT(MSCT) for coronary artery lesions with a lesion more than 50%. Methods A total of 702 coronary artery segments from 78 patients with coronary heart disease in Gaoming District People’s Hospital of Foshan from January 2016 to February 2018 were selected and analyzed the image quality and its influencing factors. Using coronary angiography as a control, the diagnostic accuracy of MSCT was observed. Results ① A total of 604 excellent image quality were obtained from 702 arterial segments, accounting for 86.04%;20 images were good in image quality, accounting for 2.85%;38 were acceptable, accounting for 5.41%;38 were poor, accounting for 5.41%;and 2 segments were unobservable, accounting for 0.28%.There were 624 evaluable segments(accounting for 88.89%) and 78 non-evaluable segments(accounting for 11.11%).② The factors affecting image quality were mainly heart rate related factors, a total of 45, accounting for 57.69%;followed by unfavorable breath holding, accounting for 25.64%.③ Using coronary angiography as the gold standard, the diagnostic sensitivity of MSCT was 74.26%, and the specificity was 96.93%, with the consistency rate of 93.11%, the positive predictive value of 82.42%, and the negative predictive value of 95.11%. Conclusion MSCT has high accuracy in the diagnosis of coronary artery disease, which can make a definitive diagnosis of coronary artery disease with more than 50% of lesions.

关 键 词：多层螺旋CT 血管造影 冠状动脉 冠状动脉造影 狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]