MSCT血管造影评价冠心病患者心肌缺血程度的临床研究  

Clinical study on evaluation of myocardial ischemia degree in patients with coronary heart disease by MSCT angiography

作　　者：尚有志 SHANG Youzhi(Department of Radiology,Jiangsu Lianyungang Saint'an Hospital,Lianyungang,Jiangsu 222100,China)

机构地区：[1]连云港圣安医院放射科,江苏连云港222100

出　　处：《影像研究与医学应用》2023年第9期25-27,共3页Journal of Imaging Research and Medical Applications

摘　　要：目的:探究多层螺旋CT(multi-slice spiral CT,MSCT)血管造影在评价冠心病患者心肌缺血程度中的应用价值。方法:选取2019年1月—2022年12月连云港圣安医院收治的疑似冠心病患者115例。所有研究对象均接受MSCT血管造影检查。以冠状动脉血管造影(coronary angiography,CAG)检查结果为金标准,分析MSCT血管造影冠状动脉狭窄检出结果及诊断效能,比较MSCT血管造影与CAG在冠状动脉狭窄程度上的检出情况,分析心肌缺血情况。结果:115例疑似冠心病患者经CAG检查,检出96例(220支)冠状动脉狭窄,19例(145支)无冠状动脉狭窄。MSCT血管造影检出94例(219支)冠状动脉狭窄,21例(146支)无冠状动脉狭窄。MSCT血管造影诊断特异度95.17%、灵敏度96.36%、准确率95.89%;Kappa=0.914,与CAG检验一致性高。CAG检查检出冠状动脉轻度狭窄44支、中度狭窄46支、重度狭窄130支;MSCT血管造影检查检出冠状动脉轻度狭窄43支、中度狭窄47支、重度狭窄129支,诊断准确率为94.09%。MSCT血管造影检查中,重度、中度、轻度狭窄的灌注积分差、心肌负荷总积分依次降低,差异有统计学意义(P<0.05)。结论:MSCT血管造影不仅可以诊断冠状动脉狭窄程度,还可以有效评估冠心病患者心肌缺血程度,具有较高的灵敏度、特异度、准确率,临床应用价值高。Objective To explore the application value of multi-slice spiral CT(MSCT)angiography in evaluating myocardial ischemia degree in patients with coronary heart disease.Methods A total of 115 patients suspected with coronary heart disease admitted to Lianyungang Saint'an Hospital from January 2019 to December 2022 were selected.All subjects underwent MSCT angiography.With coronary angiography(CAG)results as the gold standard,the detection results and diagnostic efficiency of coronary artery stenosis by MSCT angiography were analyzed,and the detection conditions of MSCT angiography and CAG in the degree of coronary artery stenosis were compared to analyze the myocardial ischemia.Results 115 patients suspected with coronary heart disease underwent CAG examination,and 96 cases(220 branches)of coronary artery stenosis were detected,while 19 cases(145 branches)had no coronary artery stenosis.MSCT angiography detected 94 cases(219 branches)of coronary artery stenosis,and 21 cases(146 branches)had no coronary artery stenosis.The diagnostic specificity,sensitivity,and accuracy of MSCT angiography were 95.17%,96.36%,and 95.89%,respectively;Kappa=0.914,with high consistency with CAG test.CAG examination detected 44 mild,46 moderate,and 130 severe coronary artery stenosis;MSCT angiography detected 43 mild,47 moderate,and 129 severe coronary artery stenosis,with a diagnostic accuracy of 94.09%.In MSCT angiography,the perfusion score difference and total myocardial load score of severe,moderate,and mild stenosis decreased sequentially,and the difference was statistically significant(P<0.05).Conclusion MSCT angiography can not only diagnose the degree of coronary artery stenosis,but also effectively evaluate the degree of myocardial ischemia in patients with coronary heart disease.It has high sensitivity,specificity,accuracy and high clinical application value.

关 键 词：多层螺旋CT血管造影 冠心病 心肌缺血 诊断 

分 类 号：R445.3[医药卫生—影像医学与核医学]