320排螺旋CT冠脉成像评估冠脉病变的临床应用价值

目的通过对比320排螺旋CT冠脉成像(冠脉CTA)与冠脉造影(CAG)的结果,探讨其评估冠脉病变的临床应用价值。方法对229例可疑冠心病患者先行冠脉CTA筛查,经其诊断为重度狭窄或闭塞的31例患者在1个月内行CAG检查,分析比较冠脉CTA对冠脉不同狭窄程度的敏感性、特异性、阳性预测值和阴性预测值,并评估其精确率。结果所有患者均成功行320排螺旋CT冠状动脉成像,获得良好的三维重建。冠脉CTA对于评估正常或重度狭窄的冠脉有较高的敏感性、特异性、阳性预测值及阴性预测值。冠脉CTA对冠脉不同狭窄程度判断的精确率达73.4%。结论 320排螺旋CT冠脉成像是一种比较可靠、简便而且安全的冠脉病变无创检查手段,对冠脉病变的评估较准确,可以作为可疑冠心病患者的一种筛查与诊断手段。

The Clinical Value of 320-slice Spiral CT Coronary Artery Angiography in Assessing Coronary Artery Diseases

Objective To explore the clinical value of 320-slice spiral CT coronary angiography (coronary CTA) in assessing coronary artery disease by contrast to the results of coronary angiography (CAG). Methods 229 patients with suspected coronary heart disease received the coronary CTA firstly. 31 patients with severe stenosis or occlusion confirmed by coronary CTA among 229 patients with suspected coronary heart disease received the CAG examination within one month. The sensitivity, specificity, positive predictive value and negative predictive values of coronary CTA were analyzed, and the exact rate was assessed. Results The 320-slice spiral CT coronary angiography was successful in all patients with good dimensional reconstruction. Coronary CTA had a higher sensitivity, specificity, positive predictive value and negative predictive value for the assessment of normal or severe stenosis coronary artery. The precise rate of coronary CTA in judging the different degree of stenosis of coronary was 73.4%. Conclusions 320-slice spiral CT coronary angiography is a reliable, simple, safe and non-invasive examination method in coronary artery diseases with accurate assessment of coronary lesions, which can be used as a screening and diagnostic tool in patients with suspected coronary heart diseases.