摘要
目的研究分析颈动脉超声评估颈动脉硬化程度与MSCTA评估冠脉狭窄程度的相关性与联合预测价值。方法选取我院心内科在2017年1月-2019年12月收治的确诊及疑似冠心病的300例患者,所有患者均进行多层螺旋CT血管造影(MSCTA)、颈动脉彩超和冠状动脉造影(CAG)检查,以CAG检查为金标准,计算上述两种诊断方法对冠心病检出率、阳性率、敏感性、特异性、预测准确性等诊断学指标,并研究分析超声评估与MSCTA评估之间的相关性。结果超声与CAG检查结果一致性为Kappa=0.588,MSCTA与CAG检查结果一致性为Kappa=0.503(P<0.05);超声评估颈动脉硬化程度准确度、敏感度、特异度、阳性预测值及阴性预测值分别为80.33%、80.95%、79.28%、86.93%、70.97%;MSCTA评估冠脉狭窄程度的准确度为81.07%,其中轻度狭窄的准确度、敏感度、特异度、阳性预测值及阴性预测值分别为83.54%、83.72%、83.33%、85.04%、81.90%;中度狭窄的分别为84.36%、65.28%、92.40%、78.33%、86.34%;重度狭窄的分别为86.83%、78.57%、88.56%、58.93%、95.19%;颈动脉超声评估颈动脉硬化程度与MSCTA评估冠脉狭窄程度呈正相关性(r=0.852,P<0.05)。结论颈动脉超声评估与MSCTA评估在诊断冠心病冠脉硬化程度与狭窄程度时与CAG金标准有较好的一致性,有助于提高冠心病的诊断价值,且其具有无创、简单便捷、重复性高等优点,值得临床推广使用。
Objective To study and analyze the correlation and joint predictive value of carotid ultrasound in evaluating the degree of carotid atherosclerosis and MSCTA in evaluating the degree of coronary stenosis.Methods 300 patients with confirmed or suspected coronary heart disease admitted to the Department of Cardiology of our hospital from January 2017 to December 2019 were selected.All patients underwent multi-slice spiral CT angiography(MSCTA),carotid color Doppler ultrasound and coronary angiography(CAG).Taking CAG examination as the gold standard,the diagnostic indexes such as detection rate,positive rate,sensitivity,specificity and prediction accuracy of the above two diagnostic methods were calculated,and the ultrasound was studied and analyzed.Results The consistency between ultrasound and CAG was Kappa=0.588,and that between MSCTA and CAG was kappa=0.503(P<0.05).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of ultrasound in evaluating the degree of carotid atherosclerosis were 80.33%,80.95%,79.28%,86.93%and 70.97%respectively.The accuracy of MSCTA in evaluating the degree of coronary artery stenosis was 81.07%,and the accuracy,sensitivity,specificity,positive predictive value and negative predictive value of mild stenosis were 83.54%,83.72%,83.33%,85.04%and 81.90%respectively.Moderate stenosis was 84.36%,65.28%,92.40%,78.33%and 86.34%respectively.Severe stenosis was 86.83%,78.57%,88.56%,58.93%and 95.19%respectively.There was a positive correlation between carotid ultrasound and MSCTA in evaluating the degree of carotid atherosclerosis(r=0.852,P<0.05).Conclusion Carotid ultrasound evaluation and MSCTA evaluation are in good agreement with CAG gold standard in diagnosing the degree of coronary sclerosis and stenosis of coronary heart disease,which is helpful to improve the diagnostic value of coronary heart disease,and it has the advantages of non-invasive,simple and convenient,and high repeatability,and is worthy of clinical application.
作者
梁耘
莫健姣
杨静爱
吴英宁
李保生
黄昌辉
LIANG Yun;MO Jian-Jiao;YANG Jing-ai;WU Ying-ning;LI Bao-Sheng;HUANG Chang-hui(Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi Zhuang Autonomous Region,China)
出处
《中国CT和MRI杂志》
2024年第5期67-69,73,共4页
Chinese Journal of CT and MRI
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200399)。
关键词
冠心病
冠脉狭窄
颈动脉硬化
颈动脉彩超
多层螺旋CT血管造影
冠状动脉造影
Coronary Heart Disease
Coronary Artery Stenosis
Carotid Atherosclerosis
Carotid Ultrasound
Multi-slice Spiral CT Angiography
Coronary Angiography
