双源CT冠脉成像在冠脉狭窄诊断中的价值

目的探讨双源CT冠状动脉成像（DSCTA）对冠状动脉狭窄诊断的准确性。方法对97例有临床冠心病症状或疑有冠心病的患者,行DSCTA检查后作选择性冠状动脉造影（CAG）,以CAG结果为金标准,探讨DSCTA检出冠状动脉狭窄病变的准确性。结果在97例患者中,以狭窄面积≥75%诊断为冠心病,DSCT诊断冠心病67例,CAG诊断冠心病71例。DSCT诊断冠心病的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为94.36%、92.31%、97.10%、85.71%及93.81%。两者相比无显著差异（P=0.68）。在CAG可评价的1455段中,1413段可由DSCTA评估,可评估率为97.11%。97例DSCTA检查出310段冠状动脉有不同程度的狭窄或闭塞,与CAG比较,得出DSCTA对〈50%、≥50%和≥75%病变的敏感性、特异性、阳性预测值及阴性预测值分别为98.35%、99.37%、94.44%、99.82%,以及90.70%、99.35%、95.12%、98.72%和83.64%、99.15%、89.32%、97.86%。在评估的1413节段冠状动脉中,DSCTA与CAG检查结果一致的为1350段,准确率为95.54%。结论 DSCTA对冠状动脉狭窄疾病的诊断准确性高,接近CAG,是一种准确、可靠的检查方法。

Diagnosis value of dual-source Computed Tomography in Coronary Artery Stenosis

Objective To investigate the accuracy of dual-source computed tomography（DSCT） coronary angiography in detection of coronary artery stenosis.Methods The study was performed in 97 patients who were established or suspected of coronary artery disease,and without any contraindications to CT scan and iodinated contrast agents.These patients were underwent DSCT as well as selective coronary angiography（CAG）.All the data of DSCT was compared with the results of CAG which were regarded as gold standard to assess the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of DSCT in classifying coronary artery stenosis.Results Of 97 patients,DSCT indicated 67 patients with severe coronary artery stenosis and CAG indicated 71 patients.The sensitivity of DSCT was 94.36%,specificity was 92.31%,positive predictive value was 97.10%,negative predictive value was 85.71%,and accuracy was 93.81%,respectively.There was no obvious difference in the measurement of coronary artery disease between DSCT and CAG.Conclusion DSCT appears to be a useful method for the detection of coronary artery stenosis with a high accuracy.