64层螺旋CT冠状动脉成像在冠心病诊断中的初步应用

目的 评价64层螺旋CT冠状动脉成像（coronary 64-slice computed tomographic angiography,64S-CCTA）在诊断冠状动脉疾病（CAD）中的临床应用价值.方法 回顾性分析92例行64S-CCTA患者完整资料,并以近期（2周之内）实施的X线冠状动脉造影检查（coronary artery disease,CAG）结果为金标准进行对比.结果 所有可用于评估1,129段冠脉中,64S-CCTA显示轻度和明显狭窄病变各为122、231段,其中各有61、198段得到CAG证实;64S-CCTA判断冠状动脉明显狭窄的灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比分别为88.39%、96.35%、85.71%、97.10%及24.22、0.12;在CAG确诊狭窄节段中,64S-CCTA在轻度狭窄和明显狭窄中分别检测出非钙化性斑块、钙化斑块各为32、65 和154、53个.结论 64S-CCTA是一种简便、可靠的无创性检查方法,对病变血管管腔狭窄及不同性质粥样硬化斑块与狭窄关系的评价有一定价值,可作为临床拟诊冠心病患者筛查的有效手段.

The Initial Application of Coronary 64-slice Spiral CT Angiography for the Diagnosis of Coronary Artery Disease

Objective The aim of our study was to evaluate the clinical values of coronary 64-slice spiral computed tomography angiography（CCTA） for the diagnosis of coronary artery disease（CAD）.Methods A retrospective analysis on the data of 92 patients was taken,who underwent both the examination of CCTA and coronary angiography（CAG） at intervals of no more than two weeks.The CAG was regarded as the golden standard to evaluate the results of CCTA.Results 1,129 coronary arteries were evaluated with 353 lesions found in CCTA, of which,the mild and significant stenosis segments were 122, 231 respectively.61, 198 lesions were consisted with CAG.The sensitivity,specificity,positive predictive value,negative predictive value,positive and negative likelihood ratio to identify significant stenosis of coronary artery with CCTA were 88.39%,96.35%,85.71%,97.10%,24.22 and 0.12 respectively.Of the mild and significant stenosis that were confirmed by CAG,the noncalcified,calcified plaques are 32, 65 and 154, 53 respectively. Conclusion As a non-invasive method,coronary 64-slice spiral CT angiography is simple,reliable for the evaluation of the stenosis of coronary artery and the relation of the characteristic of plaques and stenosis of coronary.CCTA is effective in the screening for suspected coronary artery disease.