摘要
目的探讨64层MSCT冠状动脉成像在冠心病(CHD)中的诊断价值。方法回顾性分析行64层MSCT冠状动脉成像50例,所有患者均在1月内行选择性冠状动脉造影,评价64层MSCT诊断冠脉狭窄≥50%的诊断价值以及斑块与狭窄程度的关系。结果 50例共计683个冠脉节段可用于评价;64层MSCT诊断冠脉节段≥50%狭窄与CAG符合率为84.0%(63/75),诊断冠脉节段狭窄≥50%的敏感度、特异度及准确性分别为84.0%、97.9%、96.5%;不同斑块性质对冠脉狭窄程度影响不同,单纯钙化斑块所致的狭窄程度常较轻,混合斑块所致的狭窄程度较重,而非钙化斑块所致的狭窄程度分布无一定特异性,常与CAG表现一致;钙化与非钙化斑块、钙化与混合斑块在狭窄程度的分布上差异有统计学意义(P<0.001)。结论 64层MSCT冠状动脉成像具有较高的灵敏度及特异度,对于CHD的筛查有一定的指导作用,但仍有一定的局限性。
Objective To study the clinical value of 64-slice spiral CT coronary angiography（CTCA） in diagnosis of coronary heart disease（CHD）.Methods 50 cases with 64 CTCA scan and conventional angiography（CAG） within one month were retrospectively analyzed.The sensitivity（Se）,specificity（Sp）,accuracy,and correlation of plaque and stenosis degree were all calculated to evaluate the diagnostic value on coronary stenosis（≥50%） of 64 CTCA.Results Total 683 segments of 50 patients were able to evaluate on 64 CTCA.The distribution and extent of 63 coronary arterial segments stenosis（≥50%） revealed by 64 CTCA were correlated exactly with CAG in 75 coronary arterial segment stenosis with coincidence rate of 84.0%.Compared with CAG,the Se,Sp and accuracy on 64 CTCA were 84.0%,97.9%,96.5% respectively.The different stenosed extent resulted from the different coronary plaque（P = 0.000）.Calcified plaque always caused mild lumen diameter stenosis.However,the mixed plaque aways led to serious lumen diameter stenosis.The distribution of stenosis caused by noncalcified plaque was not specific,and had a same appearance on CAG.The distribution of stenoses between calcified and noncalcified plaque or between calcified and mixed plaque had significant difference（P = 0.000）.Conclusions 64-slice spiral CTCA has higher specificity and accuracy in diagnosis of CHD,which can be used as an effective screening method,but has some limitations.
出处
《临床医学工程》
2012年第7期1035-1037,共3页
Clinical Medicine & Engineering
