冠状动脉CTA与冠状动脉造影诊断心肌桥-壁冠状动脉的对比研究  

A comparative study of coronary CTA and coronary angiography in the diagnosis of myocardial bridgeand mural coronary artery

作　　者：王录兵[1] 黄勇[1] 杨文海[1] 陈运奎 雷星[1] 符慧宏 WANG Lubing;HUANG Yong;YANG Wenhai;CHEN Yunkui;LEI Xing;FU Huihong(Department of Radiology,Taizhou First People’s Hospital,Taizhou 318000,P.R.China)

机构地区：[1]浙江省台州市第一人民医院放射科,浙江台州318000

出　　处：《医学影像学杂志》2020年第9期1603-1606,共4页Journal of Medical Imaging

摘　　要：目的观察冠状动脉CTA与冠状动脉造影在诊断心肌桥-壁冠状动脉(MB-MCA)的应用效果。方法选取我院就诊的167例疑似心肌缺血患者,分别进行冠状动脉CTA和冠状动脉造影(CAG)检查。比较两种检查方法对MB-MCA的诊断效果,测量和分析MB-MCA的长度和狭窄程度。结果冠状动脉CTA共检出MB-MCA患者37例,而CAG检查共检出MB患者20例,冠状动脉CTA对于MB-MCA的检出率显著高于CAG检查,差异有统计学意义(P<0.05);以CAG检查结果为参照,可计算出冠状动脉CTA诊断MB的敏感性为90%、特异性为87.1%、阳性预测值为48.6%和阴性预测值为98.5%;冠状动脉CTA对MB-MCA测量的长度和狭窄程度结果均大于CAG测量结果,差异有统计学意义(P<0.05)。结论冠状动脉CTA在MB-MCA的诊断和测量中具有较高的准确性,具有较好的临床应用及推广价值。Objective To observe the application value of spiral CT angiography(CTA)and coronary angiography in the diagnosis of myocardial bridge and mural coronary artery.Methods A total of 167 patients with suspected myocardial ischemia were examined by coronary CTA and coronary angiography(CAG)in our hospital.We compared the diagnostic effect of two methods for MB-MCA,measured and analyzed the length and stenosis degree of MB-MCA.Results A total of 37 MB-MCA patients were detected by coronary CTA and 20 patients were detected by CAG.The detection rate of MB-MCA by coronary CTA was significantly higher than that by CAG(P<0.05);Compared with before treatment,WBC,CRP,Lac,SCr and MAP in the two groups were significantly lower,and Pa02/Fi02 was significantly higher(P<0.05);The sensitivity,specificity,positive predictive value and negative predictive value of coronary CTA for MB-MCA were 90%,87.1%,48.6%and 98.5%,respectively;The length and stenosis degree of MB-MCA measured by coronary CTA were greater than those measured by CAG(P<0.05).Conclusion CTA has high accuracy in the evaluation and diagnosis of myocardial bridge and mural coronary artery.

关 键 词：心肌桥 壁冠状动脉 冠状动脉造影 体层摄影术 X线计算机 

分 类 号：R541.1[医药卫生—心血管疾病] R814.42[医药卫生—内科学]