64层螺旋CT冠状动脉成像和冠状动脉造影的对比研究

目的通过与冠状动脉造影比较,研究64层螺旋CT评估冠状动脉狭窄性疾病的准确性和可行性。方法收集2007年8月～2010年12月于我院行64层螺旋CT冠状动脉成像和传统冠状动脉造影的80例临床疑诊冠心病患者的影像资料。对2种方法评价冠状动脉结果进行研究,初步探讨影响图像质量的因素及64层螺旋CT对冠状动脉粥样硬化斑块的显示情况,并同时比较了冠状动脉粥样硬化斑块在各分支的分布。结果 80例冠状动脉造影显示1300节段冠状动脉(直径≥1.5mm)图像中,64SCT提供优良图可供分析为1259节段。可评估率96.8%,不可评估节段3.2%,多因心率(律)异常所致1.9%;显示230处斑块,以钙化斑块居多,发生部位以前降支最多。依据节段计算64MSCT的准确性,其诊断冠状动脉≥50%狭窄性病变敏感性为86.0%。特异性为93.3%,阳性预测值84.6%,阴性预测值93.9%,准确率91.1%。结论 64MSCT冠状动脉成像是一种简便易行、安全可靠、分险小的无创性检查,可作为冠心病高危人群普查筛选的首选方法之一。

Clinical study of 64-slice CT coronary angiography and coronary angiography

Objective Comparison with coronary angiography,64-slice spiral CT evaluation of coronary artery disease of the accuracy and feasibility.Methods Collected in August 2007-December 2010 in our hospital 64-slice CT coronary angiography and conventional coronary angiography in 80 cases of clinically suspected coronary artery disease in patients with image data.On the results of two methods to study coronary artery,a preliminary study of factors affecting image quality and 64-slice spiral CT coronary atherosclerotic plaque display case,and also compared the coronary atherosclerotic plaque in all branches the distribution.Results 80 cases of coronary angiography 1300 coronary segments(diameter ≥ 1.5mm) image,64SCT provided excellent figure for the 1259 segment for analysis.To assess the rate of 96.8%,3.2% of segments can not be assessed,usually caused by heart rate(law) abnormality 1.9%;was not 230 plaque,calcified plaque in the majority,location before descending the most.Segments based on the accuracy of the calculation 64MSCT,the diagnosis of coronary artery stenosis ≥ 50% sensitivity and 86.0% of lesions.Specificity was 93.3%,84.6% positive predictive value,negative predictive value 93.9%,accuracy was 91.1%.Conclusions 64MSCT coronary angiography is a simple,safe,reliable,small sub-risk noninvasive,high risk of coronary heart disease screening can be used as the preferred method of screening.