宽体探测器CT在高心率病人冠状动脉CT血管成像检查中的应用研究  

The study on the application of wide-detector CT in CCTA examination of the patients with high heart rate

作　　者：苏建伟[1] 李振武[1] 王秋斌 唐学弘[2] 杜静波[1] SU Jianwei;LI Zhenwu;WANG Qiubin;TANG Xuehong;DU Jingbo(Department of Radiology,People's Hospital of Beijing Daxing District,Beijing 102600,China;Department of Cardiology,People's Hospital of Beijing Daxing District,Beijing 102600,China)

机构地区：[1]北京市大兴区人民医院放射科,北京102600 [2]北京市大兴区人民医院心内科,北京102600

出　　处：《安徽医药》2022年第6期1210-1213,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨宽体探测器CT在高心率病人冠状动脉CT血管成像(CCTA)检查中的应用价值。方法回顾性收集2018年9月至2019年10月北京市大兴区人民医院的40例疑似冠心病的高心率病人,行宽体探测器CCTA检查,以侵入性冠状动脉造影(ICA)为金标准,分别基于每个冠状动脉节段、每支冠状动脉、每位病人,分析CCTA诊断冠状动脉狭窄的诊断效能。结果40例病人中,符合评价标准的冠状动脉节段共454段,CCTA诊断每个冠状动脉节段狭窄与ICA差异无统计学意义(P>0.05),Kappa值为0.87(P<0.001)。基于每个冠状动脉节段,CCTA诊断的准确率、灵敏度、特异度、阳性预测值、阴性预测值分别为95.15%、87.83%、97.64%、92.66%、95.94%,基于每支冠状动脉,CCTA诊断的准确率、灵敏度、特异度、阳性预测值、阴性预测值分别为90.00%、94.20%、84.31%、89.04%、91.49%,基于每位病人,CCTA诊断的准确率、灵敏度、特异度、阳性预测值分别为95.00%、100%、0、95.00%,基于每个冠状动脉节段、每支冠状动脉,CCTA诊断的AUC分别为0.93(P<0.001)、0.89(P<0.001)。结论宽体探测器CT诊断高心率病人冠状动脉狭窄准确性高,有较高的诊断效能。Objective To investigate the application value of wide detector CT in the coronary computed tomography angiography(CCTA)examination in patients with high heart rate.Methods A total of 40 patients with high heart rate suspected of coronary heart disease who underwent CCTA examination using wide-detector CT were collected from September 2018 to October 2019 in People's Hospital of Beijing Daxing District,retrospectively.The results of invasive coronary angiography(ICA)examination were used as the reference standard.The diagnostic efficacy of CCTA in the diagnosis of coronary stenosis based on per-segment of coronary arteries,perartery and per-patient was analyzed,respectively.Results In the 40 patients,a total of 454 coronary arterial segments met the evaluation criteria.There was no significant difference in the diagnosis of per-segment stenosis between CCTA and ICA(P>0.05),with a Kappa value of 0.87(P<0.001).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of CCTA in the diagnosis of per-segment(per-artery)stenosis was 90.00%,94.20%,84.31%,89.04%and 91.49%,respectively.The accuracy,sensitivity,specificity and positive predictive value of CCTA in the diagnosis of per-patient stenosis was 95.00%,100%,0 and 95.00%,respectively.The AUC of diagnosing per-segment and per-artery stenosis by CCTA was 0.93(P<0.001)and 0.89(P<0.001),respectively.Con⁃clusion Wide-detector CT has high diagnostic accuracy in the diagnosis of coronary stenosis in the patients with high heart rate,with high diagnostic efficacy.

关 键 词：计算机体层摄影血管造影术 冠状动脉狭窄 心率 冠状动脉造影术 宽体探测器 

分 类 号：R541.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]