多层螺旋CT冠状动脉造影对血管内支架形态变化的研究

目的 探讨多层螺旋CT冠状动脉造影在观察冠状动脉内支架彤态改变中的作用和意义.资料与方法 采用GE Light speed 64排螺旋CT对冠状动脉进行造影检查.回顾性分析167例共417个冠状动脉内支架的CT冠状动脉造影检查结果.其中男131例,女36例,年龄43-82岁,平均56.02岁.结果 417个支架中,共有145个(占34.8%)支架发生了不同形态变化.其中发生在左冠状动脉主干3个,前降支64个,回旋支30个,第一对角支3个,中间支2个,钝缘支2个;右冠状动脉主干31个,后降支10个.将145个变形支架分为4种类型:(1)局限性外压型40个,占27.6%;(2)非局限外压型64个,占44.1%;(3)支架叠加变形39个,占26.9%;(4)打开不全型2个,占1.4%.由于支架变形导致管腔狭窄,狭窄程度一般在25%～95%,平均65.47%(s=21.33).结论 64排螺旋CT冠状动脉造影是观察血管内支架形态变化和由此造成管腔狭窄的非常有效的方法,更有利于支架置入术后的随访观察.同时也为临床医师在术前对患者适应证的选择上和在术中对支架类型的选择上提供帮助.     

64层螺旋CT在冠状动脉搭桥术后的应用价值

目的:探讨64层螺旋CT在冠状动脉搭桥术后的临床应用价值。方法:采用西门子Somatom Sensation Cardiac64螺旋CT对22例冠脉搭桥术后的患者(共计44根桥血管)进行了扫描,其中11例患者同时进行了冠状动脉造影检查。结果:64层螺旋CT显示22例患者发现44支桥血管,显示率100%。44支桥血管中,33支(75%)通畅、5支(11.4%)闭塞、3支(6.8%)中重度狭窄、3支(6.8%)轻度狭窄。与冠脉造影对照,诊断桥血管明显狭窄及闭塞的敏感性100%,特异性92.9%,阳性预测值87.5%,阴性预测值100%,准确率95.2%。结论:64层螺旋CT是评价桥血管闭塞及狭窄的可靠方法。     

64层螺旋CT三维重组在气管支架置入术后随访中的应用

目的 研究64层螺旋CT三维重组对气管支架置入术后的评价及其在随访中的应用价值.资料与方法气管狭窄患者35例,男18例,女17例,年龄29～91岁,平均62.5岁.恶性气管狭窄30例,良性器质性气管狭窄5例,共置入支架40枚.支架置入术后3～7天及3～12个月内分别两次行64排多层螺旋CT检查,以容积再现(VR)、多平面重组(MPR)及CT仿真内镜成像(CTVE)多种方式重组.对支架置入术后的通畅、位置、形态、邻近气道、术后合并症等情况进行观察、评估.结果 CT图像中均观察到由金属支架引起的较小伪影,但并不妨碍判读图像.支架的形态、位置、范围、通畅程度,邻近气道的状况以及各种支架特有的并发症均清晰可见.结论 64层螺旋CT 三维成像作为一种方便、快捷、无创的检查方法能够较客观地评价气管支架置入术后情况,对于气管支架置入术后的随访有很好的应用价值.     

电子束CT血管造影对冠状动脉内支架开通的评价

目的 :探讨电子束CT(EBT)血管造影在冠状动脉支架的定位及评价支架开通中的应用价值。方法 :5 6例患者分别于冠状动脉造影术后 1月～ 6年接受EBT检查。采用单层序列平扫及增强扫描、单层或多层血流序列扫描。三维重建采用最大密度投影法 (MIP)及曲面重建法 (CPR) ,三维结果均与手术结果对照 ,其中 8例有EBT检查后的造影结果。结果 :86支冠状动脉于造影中放置 12 0枚支架 ,EBT准确定位 118枚 (98.3% )。其中 4 0支显示通畅 ,通畅率 4 6 .5 % ;37支血管狭窄 ,狭窄率 4 3% ;9支冠状动脉支架内闭塞。结论 :①EBT血管造影及三维重建可准确定位冠状动脉内支架并判断支架开通 (通畅、狭窄、闭塞 )的情况 ;血流分析可提供支架远端血管的血流曲线及定量数据 ,是评价支架开通重要的定量补充诊断 ;②EBT可作为支架置入术后长期随访的无创检查方法 ,可部分减少冠状动脉造影有创复查的次数 ;③限度 :无法准确评价狭窄的程度     

64层螺旋CT冠状动脉成像的临床应用

目的:探讨64层螺旋CT冠状动脉成像的临床应用价值。方法:对120例临床拟诊为冠心病或已确诊的冠心病患者,行64层螺旋CT血管成像,对所有原始数据采用容积再现(VR)、最大密度投影(MIP)、曲面重建(CPR)进行图像后处理,显示冠状动脉主干及主要分支。结果:心率小于70次/min且平稳时冠状动脉成像质量最佳,可较准确显示冠状动脉通畅情况、冠状动脉斑块、狭窄程度及管壁病变。对于搭桥血管及支架植入是否通畅及是否再狭窄显示良好。结论:64层螺旋CT冠状动脉成像无创、快速,对冠状动脉病变的筛选,桥血管及内支架术后疗效随访等有很大的应用价值。     

128层螺旋CT冠状动脉血管成像对冠状动脉支架置入术后的评价

目的 探讨128层螺旋CT在冠状动脉支架置入术后随访中的价值.方法 利用128层螺旋CT回顾性分析29例40枚冠状动脉支架置入术后的效果.结果 术后1年内1枚支架局部轻度狭窄,狭窄度约20%;1~2年内2枚支架管壁钙化,管腔轻度狭窄,狭窄度约30%;2~3年内1枚支架完全闭塞,1枚支架管壁钙化,管腔狭窄度约50% ;3~5年内4枚支架近段管腔明显狭窄,并伴混合型密度斑块,狭窄度在30%~60%之间;5年以上各支架未见异常.40枚支架中,39枚支架两端血管显影均良好,其中闭塞支架所在的血管整体未见显影.结论 128层螺旋CT可作为冠状动脉支架置入术后随访观察和了解冠心病进展情况的重要手段.     

64层螺旋CT冠状动脉血管造影的临床应用

目的:探讨64层探测器CT冠状动脉造影的临床应用价值。方法:对116例临床拟诊冠心病者行64层CTCA检查,采用多种重建方法对原始数据进行重建,观察64层CT对冠状动脉的显示能力、起源、冠脉内斑块性质及管腔狭窄程度,分析影响冠状动脉图像质量的因素,并对桥血管和支架通畅性进行观察。结果:左冠状动脉主干及前降支重建的最佳时相为75%R-R时相,左回旋支及右冠状动脉为65%R-R时相。以75%的相位窗重建得到容积再现的图像为最佳。64层CTCA对冠状动脉1～3级分支和部分4级分支显示清晰,对变异血管及心肌显示较佳;对冠状动脉内斑块、冠脉狭窄显示较佳;对桥血管及支架通畅和有无再狭窄显示良好。结论:64层探测器CTCA可作为冠心病、壁冠状动脉、血管变异及心肌病变的筛选手段及对冠状动脉血运重建术后复查有很高的临床应用价值。     

64层螺旋CT冠状动脉成像在冠状动脉搭桥术后的应用

目的：探讨64层螺旋CT冠状动脉造影在冠状动脉搭桥术后的应用价值。方法：24例冠状动脉搭桥术后患者在心电门控技术下采用64层螺旋CT行冠状动脉造影扫描,将所得原始数据进行容积再现、最大密度投影、曲面重建和多平面重建等图像后处理,全面观察桥血管及冠脉狭窄情况。结果：24例冠状动脉搭桥术的患者共有38条桥血管,其CTA图像均能清晰显示,其中5支桥血管轻度狭窄,6支桥血管严重狭窄。结论：64层螺旋CTA作为一种无创性的检查,在冠状动脉搭桥术后随访中具有很高的临床应用价值。     

64层螺旋CT在冠状动脉搭桥术后随访中的初步应用

目的:评价64层螺旋CT在冠状动脉搭桥术后随访中的应用价值.方法:14例搭桥术后患者行64层螺旋CT冠状动脉造影检查,分别评价CT图像桥血管近远端吻合口、桥血管本身和吻合口远端引流血管的图像质量及冠状动脉图像质量.有选择性冠状动脉造影作对照的病例,评价CT诊断桥血管通畅性和冠状动脉是否存在狭窄的可靠性,以管腔狭窄大于50%作为诊断血管狭窄的指标.结果:14例患者共发现桥血管33根,桥血管近远端吻合口可评价率分别为93.9%(31/33)和90.9%(30/33);桥血管本身近、中、远三段的可评价率分别为97.0%(32/33)、100%(33/33)和97.0%(32/33);远端引流血管的可评价率为93.9%(31/33).CTA共显示冠状动脉139段,冠状动脉节段可评价率为69.1%(96/139).CTA对评价桥血管的通畅性和冠状动脉是否存在狭窄未出现假阳性及假阴性结果.结论:64层螺旋CT在冠状动脉搭桥术后随访中具有重要的临床应用价值.     

64层螺旋CT对冠状动脉粥样硬化血管狭窄的评价

目的:探讨64层螺旋CT对冠状动脉粥样硬化各种程度血管狭窄的评估价值.方法:120例患者行64层螺旋CT血管造影(CTA)检查评价冠状动脉各段的狭窄程度,并与冠状动脉血管造影(CAG)比较,统计64层螺旋CTA诊断冠状动脉各种程度狭窄的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV).结果:64层螺旋CTA评...     

Diagnostic accuracy of 16-slice multidetector-row CT for detection of in-stent restenosis vs detection of stenosis in nonstented coronary arteries

The purpose of this study was to assess the diagnostic accuracy of 16-slice multidetector-row computed tomography (MDCT) for detecting in-stent restenosis. Fifty patients with 69 previously implanted coronary stents underwent 16-slice MDCT before quantitative coronary angiography (QCA). Diagnostic accuracy of MDCT for detection of in-stent restenosis defined as >50% lumen diameter stenosis (DS) in stented and nonstented coronary segments >1.5-mm diameter was computed using QCA as reference. According to QCA, 18/69 (25%) stented segments had restenosis. In addition, 33/518 (6.4%) nonstented segments had >50% DS. In-stent restenosis was correctly identified on MDCT images in 12/18 stents, and absence of restenosis was correctly identified in 50/51 stents. Stenosis in native coronary arteries was correctly identified in 22/33 segments and correctly excluded in 482/485 segments. Thus, sensitivity (67% vs 67% p=1.0), specificity (98% vs 99%, p=0.96) and overall diagnostic accuracy (90% vs 97%, p=0.68) was similarly high for detecting in-stent restenosis as for detecting stenosis in nonstented coronary segments. MDCT has similarly high diagnostic accuracy for detecting in-stent restenosis as for detecting coronary artery disease in nonstented segments. This suggests that MDCT could be clinically useful for identification of restenosis in patients after coronary stenting. Grant Funding: Dr Gerber was supported by a grant from the Fondation Nationale de la Recherche Scientifique of the Belgian Government (FRSM 3.4557.02).     

Evaluation of peripheral artery stent with 64-slice multi-detector row CT angiography: Prospective comparison with digital subtraction angiography

Purpose

To assess the accuracy of 64-slice multi-detector row computed tomography (MDCT) angiography in the evaluation of peripheral artery in-stent or peristent restenosis, with conventional digital subtraction angiography (DSA) as the reference standard.

Materials and methods

Forty-one patients (30 men, 11 women; mean age, 69.8 ± 9.2 years) with symptomatic peripheral arterial occlusive disease after peripheral artery stenting (81 stented lesions) underwent both conventional DSA and 64-slice MDCT angiography. Each stent was classified as evaluable or unevaluable, and every stent was divided into three segments (proximal stent, stent body, and distal stent), resulting in 243 segments. For evaluation, stenosis was graded as follows: 1, none or slight stenosis (<25%); 2, mild stenosis (25-49%); 3, moderate stenosis (50-74%); 4, severe stenosis or total occlusion (≥75%). Two readers evaluated all CT angiograms with regard to narrowing of in-stent or peristent restenosis by consensus. Results were compared with findings of the DSA.

Results

Of 81 stents, 62 (76.5%) were determined to be assessable. The metal artifact of the gold marker and motion artifact increased uninterpretability of the images of stents. Overall, 24 of 28 in-stent restenosis and 38 of 53 persistent restenosis were correctly detected by MDCT (85.7% and 71.7% sensitivity). In evaluable stents, 21 of 22 in-stent restenoses and 27 of 28 persistent restenosis were correctly detected (95.4% and 96.4% sensitivity). Additionally, as the grade of stenosis increases, the mean level of CT values in the stent lumina decreases linearly accordingly.

Conclusion

64-Slice MDCT has a high accuracy for the detection of significant in-stent or peristent restenosis of assessable stents in patients with peripheral artery stent implantation and therefore can be considered as a valuable noninvasive technique for stent surveillance.     

Evaluation of in-stent restenosis in proximal coronary arteries with multidetector computed tomography (MDCT)

The purpose of this study was to assess the ability of 16-slice computed tomography (CT) to detect in-stent restenosis of proximal coronary arteries. From November 2002 to April 2004, 134 consecutive patients with proximal stents (3.25 ± 0.47 mm) were prospectively studied. Multidetector CT (MDCT) was performed 24 h (baseline) and 6 months after angioplasty and analysed by two radiologists blinded to the results of the coronary angiography. Sensitivity, specificity, positive and negative predictive values for in-stent restenosis were compared with conventional quantitative coronary angiography (QCA). Stenosis with a diameter ≥50% was considered diagnostic of in-stent restenosis. The CT analysis was performed in 131 and 114 patients at baseline and 6 months, respectively. The in-stent lumen was evaluable in 111 (121 stents) and 99 patients (108 stents) at baseline and 6 months, respectively. The prevalence of in-stent restenosis was 22.5%. Restenoses were correctly identified in 91.7 and 87.5% by the two radiologists. The sensitivity, specificity, positive and negative predictive values for the assessment of significant in-stent restenosis were 92, 67, 43, 97% and 87, 66, 41, 95% for the radiologists, respectively. MDCT is a potential non-invasive technique for the screening of in-stent restenosis of proximal coronary arteries that needs further improvements.     

64- Versus 16-slice CT angiography for coronary artery stent assessment: in vitro experience

OBJECTIVES: We sought to assess the visualization of different coronary artery stents and the delineation of in-stent stenoses using 64- and 16-slice multidector computed tomography (MDCT). MATERIALS AND METHODS: A total of 15 different coronary stents with a simulated in-stent stenosis were placed in a vascular phantom and scanned with a 16-slice and a 64-slice MDCT at orientations of 0 degree, 45 degrees, and 90 degrees relative to the scanner's z-axis. Visible lumen diameter and attenuation in the stented and the unstented segment of the phantom were measured. Three readers assessed stenosis delineation and visualization of the residual lumen using a 5-point scale. RESULTS: Artificial lumen narrowing (ALN) was significantly reduced with 64-slice CT compared with 16-slice CT. At an angle of 0 degree, 45 degrees, and 90 degrees relative to the scanner's z-axis, the ALN for 16-slice CT was 42.2%, 39.8%, and 44.0% using a slice-thickness of 1.0 mm and 40.9%, 40.4%, and 41.6% using a slice thickness of 0.75 mm, respectively. With 64-slice CT, the ALN was 39.1%, 37.3%, and 36.0% at the respective angles. The differences between attenuation values in the stented and unstented segment of the tube were significantly lower for 64-slice CT. Mean visibility scores were significantly higher for 64-slice CT. CONCLUSION: Use of the 64-slice CT results in superior visualization of the stent lumen and in-stent stenosis compared with 16-slice CT, especially when the stent is orientated parallel to the x-ray beam.     

Assessment of coronary artery stent patency and restenosis using 64-slice computed tomography

RATIONALE AND OBJECTIVES: Restenosis remains a major limitation of coronary catheter-based stent placement. Therefore, a reliable noninvasive diagnostic method for the evaluation of stented coronary arteries would be highly desirable. Our aim was to evaluate the diagnostic accuracy of high-resolution 64-slice computed tomography (64SCT) in a pilot study for the assessment of the lumen of coronary artery stents. MATERIALS AND METHODS: Twenty-five patients underwent 64SCT of the coronary arteries and quantitative x-ray coronary angiography (QCA) after coronary artery stent placement. 64SCT coronary angiography was performed with the following parameters: spatial resolution = 0.4 x 0.4 x 0.4 mm; temporal resolution = 83-165 milliseconds; contrast agent = 80 mL at a flow rate of 5 mL/second; retrospective electrocardiogram gating. The 64SCT scans were evaluated for image quality and for the presence of significant in-stent and peri-stent (proximal and distal) stenoses. Determinations were made of the sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values (PPV and NPV) of 64SCT for the detection or exclusion of stenoses. RESULTS: A total of 46 stents were evaluated, of which 45 (98%) were of diagnostic image quality. Significant in-stent restenosis or occlusion was detected on QCA in 8/45 cases (>/=50% stenosis = 6; occlusion = 2). The sensitivity, specificity, accuracy, PPV, and NPV of 64SCT for the detection of significant in-stent disease was 75%, 92%, 89%, 67%, and 94%, respectively. Both occluded coronary artery stents were correctly identified. The sensitivity, specificity, and accuracy values of 64SCT for the detection of significant proximal peri-stent stenoses were 75%, 95%, and 93%, respectively, whereas the values for detection of significant distal peri-stent stenoses were 67%, 85%, and 84%, respectively. CONCLUSION: The high spatial and temporal resolution of 64SCT may permit improved assessment of stent occlusion and peri-stent disease, although detection of in-stent stenosis remains difficult.     

Diagnostic accuracy of 64 multislice CT angiography in the assessment of coronary in-stent restenosis: A meta-analysis

Purpose

The aim of this study was to perform a meta-analysis of the diagnostic accuracy of 64-slice CT angiography for the detection of coronary in-stent restenosis in patients treated with coronary stents when compared to conventional coronary angiography.

Materials and methods

A search of PUBMED/MEDLINE, ProQuest and Cochrane library databases for English literature was performed. Only studies comparing 64-slice CT angiography with conventional coronary angiography for the detection of coronary in-stent restenosis (more than 50% stenosis) were included for analysis. Sensitivity and specificity estimates pooled across studies were tested using a fixed effects model.

Results

Fourteen studies met selection criteria for inclusion in the analysis. The mean value of assessable stents was 89%. Prevalence of in-stent restenosis following coronary stenting was 20% among these studies. Pooled estimates of the sensitivity and specificity of overall 64-slice CT angiography for the detection of coronary in-stent restenosis was 90% (95% CI: 86%, 94%) and 91% (95% CI: 90%, 93%), respectively, based on the evaluation of assessable stents. Diagnostic value of 64-slice CT angiography was found to decrease significantly when the analysis was performed with inclusion of nonassessable segments in five studies, with pooled sensitivity and specificity being 79% (95% CI: 68%, 88%) and 81% (95% CI: 77%, 84%). Stent diameter is the main factor affecting the diagnostic value of 64-slice CT angiography.

Conclusion

Our results showed that 64-slice CT angiography has high diagnostic value (both sensitivity and specificity) for detection of coronary in-stent restenosis based on assessable segments when compared to conventional coronary angiography.     

Non-invasive evaluation of coronary artery stent patency with retrospectively ECG-gated 64-slice CT angiography

The aim of our study has been to evaluate the ability of 64-slice computed tomographic angiography (CTA) to assess coronary artery stent patency, relative to selective coronary angiography (SCA). Fifty-five consecutive patients (age range 45–80 years) with 97 previously implanted coronary artery stents underwent 64-slice CTA. The 55 patients comprised 40 subjects (group A) who were referred for follow-up SCA at a mean interval of 9.6 months after stent positioning, and 15 subjects (group B) in whom SCA was clinically indicated. Stent evaluation was performed independently by two blinded readers in terms of image quality and presence of in-stent restenosis (ISR; lumen obstruction of ≥50%). SCA was performed in 41/55 patients; 14 patients refused to undergo SCA after the 64-slice CTA exam. A total of 88 stents in 74 segments were analyzed. Twenty-one of the 74 stented segments were of poor image quality and were not considered for further analysis. Sixty-four-slice CTA detected 12/16 ISR (sensitivity: 75%) and ruled out ISR in 32/37 cases (specificity: 86%). Sixty-four-slice CTA is a valuable modality for follow-up of coronary artery stent patency only in selected patients. Appropriate candidates for follow-up 64-slice CTA should be established based on stent diameter, stent material and type as well as HR and heart rhythm. However, given the number of non-assessable segments, further work would appear necessary before 64-slice CTA can be considered a suitable procedure for broad clinical application in the evaluation of coronary artery stent patency.     

Diagnostic accuracy of 64-slice CT in the assessment of coronary stents

PURPOSE: The purpose of this study was to assess the diagnostic accuracy of 64-slice computed tomography (64-CT) coronary angiography in the detection of coronary in-stent restenosis. MATERIALS AND METHODS: Ninety-five patients (72 men and 23 women, mean age 58+/-8 years) with previous percutaneous coronary intervention with stenting and suspected restenosis underwent 64-CT (Sensation 64, Siemens). The mean time between stent deployment and 64-CT was 6.1+/-4.2 months. The scan parameters were: slices 32 x 2, individual detector width 0.6 mm, rotation time 0.33 s, feed 3.84 mm/rotation, 120 kV, 900 mAs. After the intravenous administration of iodinated contrast material (Iomeprol 400 mgI/ml, Iomeron, Bracco) and a bolus chaser (40 ml of saline), the scan was completed in <12 s. All coronary segments with a stent were assessed on 64-CT by two observers in consensus and judged as: patent, with intimal hyperplasia (lumen reduction of <50%), with in-stent restenosis (> or =50%), or with in-stent occlusion (100%). The consensus reading was compared with conventional coronary angiography. RESULTS: Four patients were excluded because of insufficient image quality. In the remaining 91, we assessed 102 stents (31 RCA; 10 LM; 54 LAD; 7 CX). In 14 (13.7%) stents, in-stent restenosis (n=8) or in-stent occlusion (n=6) was found. Intimal hyperplasia was detected in 11 (10.8%) stents. The sensitivity and negative predictive value of 64-CT for in-stent occlusion were 100% and 100%, respectively, whereas for all stenoses, >50% they were 92.9% and 98.7%, respectively. CONCLUSIONS: We found that 64-CT has a high diagnostic accuracy for the detection of in-stent restenosis in a selected patient population.     

Quantitative parameters of image quality in 64-slice computed tomography angiography of the coronary arteries

We explored quantitative parameters of image quality in consecutive patients undergoing 64-slice multi-detector computed tomography (MDCT) coronary angiography for clinical reasons. Forty-two patients (36 men, mean age 61 +/- 11 years, mean heart rate 63 +/- 10 bpm) underwent contrast-enhanced MDCT coronary angiography with a 64-slice scanner (Siemens Sensation 64, 64 mm x 0.6 mm collimation, 330 ms tube rotation, 850 mAs, 120 kV). Two independent observers measured the overall visualized vessel length and the length of the coronary arteries visualized without motion artifacts in curved multiplanar reformatted images. Contrast-to-noise ratio was measured in the proximal and distal segments of the coronary arteries. The mean length of visualized coronary arteries was: left main 12 +/- 6 mm, left anterior descending 149 +/- 25 mm, left circumflex 89 +/- 30 mm, and right coronary artery 161 +/- 38 mm. On average, 97 +/- 5% of the total visualized vessel length was depicted without motion artifacts (left main 100 +/- 0%, left anterior descending 97 +/- 6%, left circumflex 98 +/- 5%, and right coronary artery 95 +/- 6%). In 27 patients with a heart rate < or = 65 bpm, 98 +/- 4% of the overall visualized vessel length was imaged without motion artifacts, whereas 96+/-6% of the overall visualized vessel length was imaged without motion artifacts in 15 patients with a heart rate > 65 bpm (p < 0.001). The mean contrast-to-noise ratio in all measured coronary arteries was 14.6 +/- 4.7 (proximal coronary segments: range 15.1 +/- 4.4 to 16.1 +/- 5.0, distal coronary segments: range 11.4 +/- 4.2 to 15.9 +/- 4.9). In conclusion, 64-slice MDCT permits reliable visualization of the coronary arteries with minimal motion artifacts and high CNR in consecutive patients referred for non-invasive MDCT coronary angiography. Low heart rate is an important prerequisite for excellent image quality.     

64层螺旋CT冠状动脉成像临床应用评价

目的:评价64层螺旋CT冠状动脉成像(64SCTCA)的图像质量和在诊断冠状动脉疾病的临床价值。方法:搜集35例患者64SCTCA的完整资料,并以近期实施的选择性X线冠状动脉成像(SCA)结果为金标准进行对比,对64SCTCA显示的冠状动脉主支及主要分支情况进行分级评估。结果:35例病例可用于评估的冠状动脉共计368支,成功率达95.6%。其中SCA共显示74个节段冠脉有中、重度狭窄(≥50%)。MSCTCA诊断中重度狭窄的敏感性为86.5%,特异性为97.3%,阳性预测值88.9%,阴性预测值96.6%。经配对χ2检验,P>0.05,证明两种检查方法在发现冠状动脉病变方面差异无统计学意义。结论:64层螺旋CT冠状动脉成像是一种无创、快速的成像方法,对诊断冠状动脉≥50%狭窄有较高的敏感性和特异性,适合用于临床怀疑冠心病的患者SCA前的筛选检查。