双源CT冠脉显像对老年患者冠脉疾病的诊断价值

目的探讨双源CT的冠脉成像技术对老年患者的诊断价值。方法对我院849例拟诊或确诊老年冠心病患者的心脏双源CT检查结果进行分析,评价双源CT对老年患者冠脉成像的特点及优势。结果双源CT能够清晰显示冠脉并发现冠脉连接/起源异常,对老年患者心肌桥血管的发现比例高达32.86%,并伴随相应节段冠脉异常比例达13.62%。与冠脉造影对比显示,双源CT对冠脉狭窄的阳性病变诊断的敏感度、特异度、阳性预测值、阴性预测值分别为71.43%、92.31%、71.43%、92.31%,准确度达到89.23%。结论双源CT能够较清晰地显示老年患者冠脉的起源和管腔狭窄情况,和金标准冠脉造影比较,显示出较高的准确度,可作为老年患者冠脉疾病了解的初筛手段。

The clinic application of dual source CT in the coronary angiography with old patients

Objective To explore the clinic value of the dual source computed tomography （DSCT）in old patients with coro- nary artery disease （CAD）. Methods A total of 849 consecutive patients with high probability of CAD underwent DSCT coronary an- giography. 38 patients of the recruited patients underwent selected coronary angiography at the same ＂time. Twe physicians indepengdent- ly assessed the images of all coronary segments. Results DSCT truely displayed the sources and structural variations of coronary arter- y. The diagnosis ratio of myocardial bridge in DACT was up to 32.86%. And 13.62% of the patients with myocardial bridge were foun- ded to have abnormality in the corresponding coronary. For the detection of stenosis of coronary on the per segment basis, DSCT showed a overall Sensitivity, specificity, positive predictive value, predictive value, accuracy ratio for evaluating CAD were 71.43% , 92.31% , 71.43 %, 92.31% , 89.23 % respectievely. Conclusions The DSCT has excellent sensitivity and specificity in detecting CAD, and also can give fairly accurate assessment of stenosis severity in most old patients as compared to CAG.