冠脉动脉慢性完全性闭塞的多层螺旋CT诊断  

MSCT Diagnosis of Chronic Complete Occlusion of Coronary Arteries

作　　者：刘世潮 蔡胜利 陈宇 LIU Shi-chao;CAI Sheng-li;CHEN Yu(Department of Medicine Imaging Center,Pukou District Hospital of Traditional Chinese Medicine,Nanjing 210000,Jiangsu Province,China)

机构地区：[1]南京市浦口区中医院医学影像中心,江苏南京210000

出　　处：《中国CT和MRI杂志》2021年第2期82-83,101,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨64排螺旋CT冠脉成像(64 MSCTCA)对慢性完全闭塞性病变(CTO)的诊断价值。方法收集2014年1月至2019年2月在我院经冠脉造影(CAG)证实且术前接受64 MSCT-CA检查的CTO病变患者94例,以CAG为“金标准”,评价64 MSCT-CA对CTO病变的诊断效能。结果94例患者(282支主要冠脉血管)经CAG检查发现完全闭塞病变108处,其中前降支37处,左回旋支21处,右冠50处。以CAG为“金标准”,64 MSCT-CA诊断CTO的敏感度为90.74%,特异度为98.28%,准确度为95.39%,阳性预测值为97.03%,阴性预测值为94.48%。Kappa一致性检验显示,64 MSCT-CA诊断与CAG诊断具有较好一致性(Kappa值=0.901,P=0.000)。结论64 MSCT-CA对CTO病变有较高诊断价值,与CAG检查有着较好的一致性。Objective To explore the diagnostic value of 64-slice spiral CT coronary angiography(64 MSCT-CA)in the diagnosing chronic total occlusion(CTO).Methods 94 patients with CTO lesions were confirmed by coronary angiography(CAG)and received 64 MSCT-CA before surgery from January 2014 to February 2019 were collected.CAG was used as the gold standard to evaluate the diagnostic efficacy of 64 MSCT-CA on CTO lesions.Results Among the 94 patients(282 major coronary vessels),there were 108 sites of complete occlusion by CAG examination,including 37 anterior descending branches,21 left circumflexs,and 50 right coronary lobes.With CAG as the gold standard,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 64 MSCT-CA in CTO diagnsosis were 90.74%,98.28%,95.39%,97.03%and 94.48%.The Kappa consistency test showed that the 64 MSCT-CA diagnosis was in good consistency with the CAG diagnosis(Kappa value=0.901,P=0.000).Conclusion 64 MSCT-CA has a high diagnostic value on CTO lesions and has a good consistency with CAG examination.

关 键 词：慢性完全闭塞性病变 CT冠脉成像 冠脉造影 

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]