摘要
目的:探讨64层螺旋CT冠状动脉造影(CTA)和磁共振心脏多技术扫描联合诊断冠心病(CHD)的临床应用价值。材料和方法:28例拟行冠状动脉造影(CAG)的冠心病患者,于术前1周分别完成64层螺旋CTA及磁共振心脏多技术扫描,以CAG为标准分析CTA与MRI诊断冠心病的各项指标,评价平行试验和系列试验的诊断价值。结果:64层螺旋CTA判断中、重度狭窄血管(≥50%)的敏感度、特异度、准确度、阳性预测值、阴性预测值为87.88%、98.73%、95.54%、96.67%、95.12%。磁共振多技术扫描左室增大8例,室壁明显变薄7例。在476个节段中,29个节段(6.09%)运动减弱或不运动,9个节段(1.89%)出现矛盾运动或室壁瘤。左心功能改变,与正常值相比有统计学意义(P<0.001)。MRI间接推断中、重度狭窄血管(≥50%)的敏感度、特异度、准确度、阳性预测值、阴性预测值为93.75%、86.54%、89.29%、81.08%、95.74%。两种方法联合平行试验和系列试验总的敏感度、特异度分别为99.24%、85.44%,82.39%、99.83%。结论:64层螺旋CTA和磁共振心脏多技术扫描诊断冠心病各有优势,两者互相补充,联合使用可方便、全面、准确、无创地对冠心病患者进行评估。
Purpose： To discuss the value of the combination of 64 - slice spiral CTA and cardiac multimodality MR imaging technology in diagnosing coronary artery disease. Materials and Methods： Totally 28 patients with coronary artery disease were underwent 64- slice CT coronary angiography （CTA） and cardiac multimodality MR scanning one week before coronary angiography（CAG）. The results were compared in terms of diagnostic parameters. Results： When CAG was used as gold standard of coronary artery disease, the sensitivity, specificity, accuracy, positive predicitive and negative predictive of medium and severe stenosis（≥ 50%） of coronary artery by 64- slice CTA were 87.88%, 98.73%, 95.54%, 96.67%, 95.12%. The cardiac multimodality MR scanning showed left ventricle volumes enlarged in 8 cases and the ventricle walls thinned in 7 cases. In all the 476 segments, 29 segments（6.09% ） were hypokinetic or akinetic, and 9 segments （1.89%） were paradoxical motions or ventricular aneurysms. The difference of left ventricular function had statistical significance compared with normal（P 〈 0. 001） . The sensitivity, specificity, accuracy, positive predicitive and negative predictive of medium and severe stenosis（ ≥ 50 % ） of coronary artery which were inferred according to the coronary anatomic distribution of myocardial blood suppying by MRI indirectly were 93.75%, 86.54%, 89.29%, 81.08%, 95.74%. The total sensitivity and specificity of the parallel and serial test were 99.24%, 85.44% ; 82.39%, 99.83%. Conclusion： Both 64 - slice spiral CTA and cardiac multimodality MR imaging are valuable in the diagnosis of CHD and they are complementary. If use the two methods combinatively, we can assess CHD conveniently, completely,accurately and non - invasively.
出处
《中国医学计算机成像杂志》
CSCD
2008年第1期33-38,共6页
Chinese Computed Medical Imaging
基金
国家自然科学基金(30270419)
