冠状动脉CT血管成像对冠心病病变程度及部位的诊断价值  

Diagnostic value of coronary CT angiography in the degree and location of coronary heart disease

作　　者：徐利军 魏雪 刘娇 张光勇 孙雷 XU Lijun;WEI Xue;LIU Jiao;ZHANG Guangyong;SUN Lei(Medical Imaging Department,Mianyang 404 hospital,Mianyang 621051,Sichuan,China)

机构地区：[1]绵阳四〇四医院医学影像科,四川绵阳621051

出　　处：《西部医学》2020年第3期456-459,共4页Medical Journal of West China

基　　金：四川省医学会科研课题(S15094)。

摘　　要：目的探讨冠状动脉CT血管成像(CTA)对冠心病病变程度及部位的诊断价值。方法选择2016年2月~2019年2月我院收治的冠心病患者共268例,分别行冠状动脉CTA及冠状动脉造影(CAG)检查。以CAG为金标准,对比CTA对冠心病病变程度及部位的诊断一致性,以及灵敏度、特异度、准确度。结果CT血管成像对中、重度狭窄程度诊断的Kappa值分别为0.718、0.803,诊断中、重度狭窄程度的灵敏度、特异度、准确度分别为95.70%、94.94%,81.82%、92.00%,94.23%、94.51%。对单支病变及多支病变诊断的Kappa值分别为0.785、0.757,诊断单支、多支病变的灵敏度、特异度、准确度分别为97.04%、95.15%,83.33%、91.67%,95.42%、94.78%。对病变部位在前降支、回旋支及右冠脉诊断的Kappa值分别为0.825、0.718、0.846,诊断病变部位在前降支、回旋支、右冠脉的灵敏度、特异度、准确度分别为97.14%、94.74%、96.92%,87.50%、80.00%、90.91%,95.87%、92.54%、91.25%。结论冠状动脉CT血管成像对冠心病的重度狭窄程度,单支病变、多支病变,病变部位在前降支及右冠脉诊断的一致性较好,对中度狭窄程度,病变部位在回旋支诊断的一致性一般。Objective To investigate the diagnostic value of coronary CT angiography(CTA)in the degree and location of coronary heart disease.Methods From February 2016 to February 2019,268 patients with coronary heart disease in our hospital were selected for CTA and CAG.With CAG as the gold standard,the consistency,sensitivity,specificity and accuracy of CTA in the diagnosis of coronary heart disease were compared.Results The kappa value of CT angiography in the diagnosis of moderate and severe stenosis was 0.718 and 0.803 respectively.The sensitivity,specificity and accuracy of CT angiography in the diagnosis of moderate and severe stenosis were 95.70%,94.94%,81.82%,92.00%,94.23%and 94.51%,respectively.Kappa was 0.718 and 0.803 for single and multi vessel lesions respectively.The sensitivity,specificity and accuracy of single and multi vessel lesions were 97.04%,95.15%,83.33%,91.67%,95.42%and 9478%,respectively.The kappa values of the lesions were 0.825,0.718,0.846,respectively.The sensitivity,specificity and accuracy of the lesions were 97.14%,94.74%,96.92%,87.50%,80.00%,90.91%,95.87%,92.54%,91.25%,respectively.Conclusion CT angiography of coronary artery has good consistency in the diagnosis of severe stenosis of coronary heart disease,single vessel disease,multi vessel disease,lesion location in anterior descending artery and right coronary artery,moderate stenosis,lesion location in circumflex artery.

关 键 词：冠状动脉CT血管成像 冠状动脉造影 冠心病 诊断价值 

分 类 号：R445.3[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]