摘要
目的探讨多层螺旋CT（MSCT）在心肌桥中的诊断能力。方法对51例临床怀疑为冠状动脉粥样硬化性心脏病的患者进行了MSCT、常规冠状动脉造影（CAG）以及血管内超声检查（将后2种检查方法统称为创伤性技术），共82支冠状动脉，其中的80支冠状动脉无明显伪影，可供评价。分别统计MSCT对心肌桥检出的敏感度、特异度和准确度。观察者间的一致性检验采用Cohen Kappa检验方法。结果CAG及血管内超声共发现26例心肌桥，所有心肌桥均发生于左前降支中段附近。MSCT正确检出26例前降支心肌桥中的23例，其敏感度88％（23／26），特异度96％（52／54），准确度94％（75／80），2名医师对心肌桥的检出Kappa值为0．62。MSCT尚检出2例心肌桥，为创伤性技术所漏诊。将创伤性技术和MSCT综合结果作对照，则MSCT心肌桥检出的敏感度、特异度和准确度分别为89％（25／28）、91％（21／23）和90％（46／51）。结论MSCT作为一种无创性成像方法应用于心肌桥的诊断，方法可行，结果可靠。
Objective To investigate the ability of electrocardiogram-gated muhislice CT（MSCT） in the diagnosis of myocardial bridging. Methods Fifty-one patients（82 coronary arteries） with suspected coronary artery disease underwent multi-detector row CT, conventional coronary angiography and intravascular ultrasonography as well. The sensitivity, specificity and accuracy of MSCT for the detection of myocardial bridging were determined. The interobserver agreement was calculated by using Cohen＇s Kappa test. Results A total of 26 tunneled arteries exclusively located near the middle segment of left anterior descending coronary artery were found by coronary angiography and intravascular ultrasonography. Compared to the invasive methods, MSCT correctly detected 23 of 26 myocardial bridges with a sensitivity of 88% （23/26）, specificity of 96% （ 52/54 ） and accuracy of 94% （ 75/80 ） . The Kappa value for overall interobserver variation was 0.62. Two myocardial bridges diagnosed by MSCT were missed with the invasive method. With the results of invasive and non-invasive methods combined as the standard of reference, the overall sensitivity, specificity, and accuracy of MSCT in detecting myocardial bridging were 89% （25/28）, 91% （21/23）, and 90% （46/51）, respectively. Conclusion As a non-invasive imaging modality, MSCT is feasible and reliable in the detection of myocardial bridging.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2008年第5期498-502,共5页
Chinese Journal of Radiology
