摘要
目的探讨静息状态下CT冠状动脉造影(CT coronary angiography,CTCA)与心肌首过灌注成像联合诊断冠心病的临床可行性,并对其准确性进行分析。方法选取在我院接受诊断或治疗的可疑或确定冠心病患者52例,行CTCA和冠状动脉造影(cornary angioiography,CAG)检查,并以CTCA的数据进行心肌首过灌注成像分析,以冠脉造影及负荷/静息心肌灌注显像为诊断金标准,比较CTCA和CTCA+心肌首过灌注成像诊断冠状动脉狭窄及心肌灌注缺损诊断的准确性。结果 CAG显示144支血管中,中、重度狭窄55支。CTCA显示中、重度狭窄56支,CTCA结合心肌首过灌注成像显示冠脉狭窄阳性54支;参照CAG结果,CTCA对冠状动脉狭窄诊断的敏感性为78.2%,特异性85.4%,阳性预测值76.8%,阴性预测值86.4%,准确率82.6%;参照CAG结果,CTCA联合心肌首过灌注成像对冠状动脉狭窄诊断的敏感性为92.7%,特异性96.6%,阳性预测值为94.4%,阴性预测值为95.6%,准确率为95.1%,CTCA与CTCA结合心肌首过灌注成像各诊断指标之间差异有统计学显著性(P<0.05)。以负荷/静息心肌灌注显像为参考标准,CTCA+心肌首过灌注成像诊断心肌灌注缺损的灵敏度、特异度、阳性预测值、阴性预测值及准确度分别为88.41%、93.01%、73.49%,97.34%及92.19%。结论静息状态下,CTCA+心肌首过灌注成像可以提供关于冠脉解剖学和功能学的信息,临床应用价值较高,且对冠心病的诊断准确性较高,值得临床进一步推广使用。
Objective To investigate the clinical feasibility and accuracy of computed tomography coronary augiography combined with CT first-pass myocardial peffusion imaging in the diagnosis of coronary heart disease at rest. Methods 52 patients with suspected or diagnosed as coronary heart disease in our hospital were selected. Cornary angioiography and CTCA were examined for the patients, and the data of CTCA were analyzed by CT first-pass myocardial peffusion imaging. Taking CAG and load/ resting myocardial peffusion imaging as the gold standard, the accuracy of CTCA and CTCA ＋ myocardial first peffusion imaging in the diagnosis of coronary artery stenosis and the myocardial peffusion defect diagnosis were compared. Results CAG showed that there were 55 cases of moderately severe stenosis in 144 vessels. CTCA showed there was 56 cases of moderate stenosis. CTCA combined with CT first-pass myocardial perfusion imaging showed that there was 54 cases of positive translation of coronary stenosis. According to the results of CAG, the sensitivity of CTCA diagnosis was 78.2% , the specificity was 85.4% ,the positive predictive value was 76.8%, the negative predictive value was 86.4%, and the accuracy rate was 82.6% ; and the sensitivity of CTCA combined with CT first-pass myocardial peffusion imaging was 92.7% , the specificity was 96.6% , positive predictive val- ue was 94.4% , positive predictive value was 95.6% , and the accuracy rate was 95.1% , There were statistically significant （ P 〈 0.05） on the different diagnostic criteria between CTCA and CTCA combined with CT first-pass myocardial peffusion imaging. Taking load/resting myocardial perfusion imaging as the reference standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CTCA ＋ myocardial first peffusion imaging in the diagnosis of myocardial perfusion defeet degree were 88.41% , 93. 01% , 73.49% , 97.34% and 92.19% , respectively. Conclusion CTCA combined with CT first-pass myocardial peffusion imaging
出处
《医学影像学杂志》
2016年第8期1417-1421,共5页
Journal of Medical Imaging
关键词
CT冠状动脉造影
CT首过心肌灌注成像
冠心病
冠状动脉狭窄
CT coronary angiography
CT first-pass myocardial perfusion imaging
Coronary artery disease
Coronary artery stenosis
