CTA钙化积分与冠状动脉造影诊断冠状动脉狭窄程度的对比研究  

Calcification scores of CT angiography and coronary angiography in diagnosing severity of coronary stenosis:a comparative study

作　　者：魏庆民[1] 张华龙[1] 张友良[1] 史永堂[1] 孙新鑫[1] 樊延明[1] 林书坡[1] 王世杰[1] Wei Qingmin;Zhang Hualong;Zhang Youliang;Shi Yongtang;Sun Xinxin;Fan Yanming;Lin Shupo;Wang Shijie(First Department of Cardiology,People's Hospital of Xingtai City,Xingtai 054031,China;不详)

机构地区：[1]邢台市人民医院心内一科,邢台054031

出　　处：《中国循证心血管医学杂志》2022年第5期578-580,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河北省基础研究项目(H2018108089)。

摘　　要：目的对比分析CT血管造影术(CTA)钙化积分和冠状动脉造影(CAG)对冠状动脉(冠脉)狭窄程度的诊断作用。方法选取2019年7月至2020年6月于邢台市人民医院心内一科就诊并接受CTA和冠脉造影检查的冠脉病变患者96例,以冠脉造影做为评价冠脉狭窄程度“金标准”,评价CTA及钙化积分筛查冠脉狭窄的灵敏度、特异性,阳性预测值,通过计算Kappa值评价CTA和CAG检查结果的一致性。结果CTA诊断冠脉病变的灵敏度为0.984(95%CI:0.931~1.026)、特异度为0.747(95%CI:0.695~0.804)、准确度为0.955(95%CI:0.901~1.013)、阳性预测值为0.956(95%CI:0.898~1.006),Kappa值为0.773(95%CI:0.712~0.841),提示CTA与CAG对冠脉病变检测具有较好的一致性。CTA对冠脉轻度狭窄诊断灵敏度0.977(95%CI:0.938~1.014)、中度狭窄诊断灵敏度0.962(95%CI:0.917~1.011)、重度狭窄诊断灵敏度0.959(95%CI:0.913~1.008)。CTA检测发现79例(82.3%)患者呈现大小不等的钙化积分;冠脉造影检测发现冠脉轻度狭窄14例(14.6%),冠脉中、重度狭窄77例(80.2%),经统计学分析,CTA钙化积分检出率和CAG冠脉狭窄中、重度检测阳性率比较,差异无统计学意义(P>0.05)。结论CTA诊断冠脉狭窄具有较高的灵敏度和准确度,CTA钙化积分与冠脉中、重度狭窄具有明显相关性。Objective To compare calcification scores of CT angiography(CTA)and coronary angiography(CAG)in diagnosing severity of coronary stenosis.Methods The patients with coronary artery lesions received CTA or CAG examinations(n=96)were chosen from the First Department of Cardiology in People’s Hospital of Xingtai City from July 2019 to June 2020.Taken CAG as“gold standard”in evaluation of severity of coronary stenosis,the sensitivity,specificity and positive predictive value(PPV)were reviewed in screening coronary stenosis by CTA and calcification scores.The consistency of CTA and CAG results was reviewed through calculating Kappa value.Results The sensitivity of CTA was 0.984(95%CI:0.931~1.026),specificity was 0.747(95%CI:0.695~0.804),accuracy was 0.955(95%CI:0.901~1.013),PPV was 0.956(95%CI:0.898~1.006)and Kappa value was 0.773(95%CI:0.712~0.841)in diagnosis of coronary artery lesions.The results indicated that CTA and CAG had a higher consistency.The sensitivity of CTA was 0.977(95%CI:0.938~1.014)in diagnosis of mild coronary stenosis,0.962(95%CI:0.917~1.011)in diagnosis of moderate coronary stenosis and 0.959(95%CI:0.913~1.008)in diagnosis of severe coronary stenosis.CTA examination found there were different calcification scores in 79 patients(82.3%).CAG examination found there were there were 14 patients(14.6%)with mild coronary stenosis and 77 patients(80.2%)with moderate and severe coronary stenosis.The results of statistical analysis showed that the comparison between detection rate of calcification scores by CTA and positive detection rate of moderate and severe coronary stenosis by CAG had no statistical difference(P>0.05).Conclusion CTA has a higher sensitivity and accuracy in coronary stenosis diagnosis,and CTA calcification scores is significantly correlated to moderate and severe coronary stenosis.

关 键 词：CT血管造影术 钙化积分 冠脉造影 冠脉狭窄 

分 类 号：R542[医药卫生—心血管疾病]