CT血管成像参数对冠脉狭窄的诊断价值  

Diagnostic value of CT angiography parameters for coronary stenosis

作　　者：肖欢[1] 谢梦雨 胡龙翔凤 王晋秋[1] 王敏[2] XIAO Huan;XIE Meng-yu;HU Long-xiang-feng;WANG Jin-qiu;WANG Min(Department of Radiology,Central Hospital of Mianyang City,Mianyang,Sichuan,621000,China)

机构地区：[1]绵阳市中心医院放射科,四川绵阳621000 [2]绵阳市中心医院心血管内科,四川绵阳621000

出　　处：《心血管康复医学杂志》2023年第4期367-372,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究CT血管成像(CTA)参数对冠脉狭窄的诊断价值。方法:依据冠脉狭窄程度,于我院行CT检查的176例冠脉狭窄患者被分为轻度狭窄组(65例)、中度狭窄组(59例)及重度狭窄组(52例),比较各组一般临床资料及CTA参数,并分析CTA参数与冠脉狭窄程度的相关性及CTA参数对冠脉狭窄程度的诊断价值。结果:CTA检测冠脉狭窄准确率为92.61%。与轻度狭窄组比较,中度狭窄组、重度狭窄组最小管腔面积(MLA)、最小管腔直径(MLD)均显著降低,狭窄面积百分比(%AS)、狭窄直径百分比(%DS)均显著升高;与中度狭窄组比较,重度狭窄组MLA、MLD均显著降低,%AS、%DS均显著升高(P均=0.001)。Spearman相关性分析显示,%AS、%DS与冠脉狭窄程度呈显著正相关(r=0.829、0.881,P均=0.001),MLA、MLD与冠脉狭窄程度呈显著负相关(r=-0.824、-0.674,P均=0.001)。ROC曲线显示,MLA、MLD、%AS、%DS联合检测评估冠脉狭窄程度的曲线下面积(AUC)为0.878,灵敏度为88.29%,特异度为84.62%;四项联合检测的AUC显著高于各单独检测,灵敏度显著高于MLA、%AS、%DS单独检测,特异度显著高于MLD单独检测(P<0.05或<0.01)。结论:CTA参数与冠脉狭窄程度具有显著相关性,且CTA参数联合检测对冠脉狭窄严重程度具较高诊断价值。Objective:To study diagnostic value of CT angiography(CTA) parameters for coronary stenosis.Methods:According to coronary stenosis severity,a total of 176 patients with coronary stenosis undergoing CT examination in our hospital were divided into mild stenosis group(n=65),medium stenosis group(n=59) and severe stenosis group(n=52).General clinical data and CTA parameters were compared among all groups.Correlation between CTA parameters and coronary stenosis severity and diagnostic value of CTA parameters for coronary stenosis severity were analyzed.Results:Accuracy rate of CTA in detecting coronary stenosis was 92.61%.Compared with mild stenosis group,there were significant reductions in minimal lumen area(MLA) and minimal lumen diameter(MLD),and significant rise in percentages of area stenosis(%AS) and diameter stenosis(%DS) in medium stenosis group and severe stenosis group;compared with medium stenosis group,there were significant reductions in MLA and MLD,and significant rise in %AS and %DS in severe stenosis group(P=0.001 all).Spearman correlation analysis indicated that %AS and %DS were significant positively correlated with coronary stenosis severity(r=0.829,0.881,P=0.001 both),and MLA and MLD were significant inversely correlated with coronary stenosis severity(r=-0.824,-0.674,P=0.001 both).ROC curve analysis indicated that area under curve(AUC) of MLA,MLD,%AS,%DS combined detection for evaluating coronary stenosis severity was 0.878,sensitivity was 88.29%and specificity was 84.62%.AUC of combined detection was significantly higher than those of single detections,sensitivity was significantly higher than those of single MLA,%AS and %DS detection,and specificity was significantly higher than that of MLD detection(P0.05 or 0.01).Conclusion:CTA parameters are significantly correlated with coronary stenosis severity,and combined detection of CTA parameters possesses high diagnostic value for coronary stenosis severity.

关 键 词：冠状动脉狭窄 诊断 诊断显像 

分 类 号：R543.3[医药卫生—心血管疾病]