摘要
目的探讨64排螺旋CT血管造影(CTA)对冠状动脉狭窄的诊断价值。方法所选病例为2014年11月至2017年6北京市中关村医院及首都医科大学附属北京同仁医院心血管中心疑诊为冠心病的63例患者,于入院后3 d内行64排冠状动脉CTA,对冠状动脉的主干和分支进行节段性重建和分析,以冠状动脉血管造影(CAG)为金标准进行对比分析。结果 63例患者共检查冠脉节段807段,最终选取801个节段进行分析。CTA共检出冠脉狭窄31例(91节段)。其中轻度狭窄14例,位于右冠主干6例,左前降支5例,左回旋支3例。中度狭窄9例,位于右冠主干2例,左前降支5例,左回旋支2例。重度狭窄及闭塞8例,均位于左前降支。CTA对本组冠脉狭窄的敏感性为82.6%,特异性97.2%,阳性预测值78.0%,阴性预测值97.9%。结论 64排螺旋CT具有很高的空间、密度分辨率,其扫描时间短、成像清晰,强大的后处理技术可以准确直观的显示狭窄冠脉的细节。CTA可清晰显示冠脉病变段血管的狭窄部位、狭窄程度、桥血管及支架管腔,对冠心病的早期诊断有重要的临床价值。
Objective To investigate the diagnostic value of CTA for the coronary artery stenosis. Methods Selected cases for November 2014 to June 2017 in Beijing zhongguancun hospital and Beijing tongren hospital cardiovascular center affiliated to the capital university of medical sciences, and history for 63 patients of coronary heart disease（CHD）, 3 days after admission professionals 64 coronary CTA, trunk and branch of coronary artery segmental reconstruction and analysis, in coronary artery angiography（the CAG） as the gold standard were analyzed. Results A total of 63 patients were examined for 807 segments of the coronary artery segment, of which 7 segments were not able to meet the CTA diagnostic requirements, and 801 segments were selected. A total of 31 cases of coronary artery stenosis were detected by CTA（section 91）. Among them, there were 14 cases with mild stenosis, 6 in the right coronary artery, 5 in the left anterior descending branch and 3 in the left. There were 9 cases of moderate stenosis, 2 in the right coronary artery, 5 in the left anterior descending branch and 2 in the left. Severe stenosis and occlusion of 8 cases were all located in the left anterior descending branch.The sensitivity of CTA to the coronary stenosis was 82.6%, specificity 97.2%, positive predictive value 78.0%, and negative predictive value 97.9%. Conclusion The 64-slice spiral CT has a high spatial and density resolution, and its scanning time is short and the imaging is clear. The powerful post-processing technique can accurately and visually display the details of narrow coronary arteries. CTA can clearly show the stenosis, stenosis, bridge vessels and stents of coronary artery lesions, and have important clinical value for early diagnosis of coronary heart disease.
作者
姚福会
毕妍
王雷
Yao Fuhui;Bi Yan;Wang Lei(Radiology Department of Zhongguancun Hospital,Beijing 100190,China;Beijing Chaoyang District Disease Prevention and Control Center,Beijing 100190,China;Cardiovascular Center,Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing 100190,China)
出处
《血管与腔内血管外科杂志》
2018年第1期43-47,共5页
Journal of Vascular and Endovascular Surgery
