CT血管成像对冠心病的诊断价值

目的：评估多层螺旋CT血管造影（ CTA ）对冠状动脉病变诊断的准确率，以期代替常规冠状动脉造影。材料及方法：回顾性收集57例冠心病患者的临床资料，均行冠状动脉造影及多层螺旋冠状动脉CTA成像。共选择931段冠脉进行研究，其中95段表现出不同程度的狭窄：34段狭窄程度＜50％，43段狭窄程度为50％～70％，18段狭窄＞70％。结果：64排CTA对诊断冠脉狭窄程度＜50％、50％～70％及＞70％的敏感性及特异性分别为78．57％、99．34％，81．08％、99．33％和87．5％、99．78％；阳性预测值及阴性预测值分别为78．57％、99．34％，83．33％、99．22％和87．5％、99．78％；诊断准确率分别为88．95％、90．2％及93．64％。常规冠脉造影及64排冠脉CTA成像对中度狭窄（50％～70％）及重度狭窄（＞70％）的诊断准确率差异无统计学意义（P＞0．05），但对轻度狭窄（＜50％）的诊断差异有统计学意义（P＜0．05）。结论：64排冠脉CTA成像对中重度狭窄的冠脉诊断准确率较高，可以取代常规冠脉造影。

Diagnostic efficacy of CT angiography in coronary artery disease

Objective：To evaluate the diagnostic efficacy of multi-detector computed tomography angiography （MDCTA） as an alternative to conventional coronary angiography in the assessment of coronary artery disease .Materials and Methods： This retrospective study enrolled 57 patients with coronary artery disease , who underwent both conventional coronary angiography （ CCA ） and multi-detector computed coronary angiography . Total of 931 accessible segments were studied .Of which 95 segments showed varied degree of stenosis , with 34 segments 〈50%stenosis, 43 segments 50% 70% stenosis and 18 segments 〉70% stenosis.Results： The sensitivity and specificity of 64-slice MDCT for detecting stenosis in 〈50%, 50% 70% and 〉70% were 78 .57% and 99.34%,81.08% and 99.33%,87.5% and 99.78%respectively.The positive predictive value （ PPV） and negative predictive value （ NPV） were 78.57% and 99.34%,83.33% and 99.22%,87.5% and 99.78%respectively.Over all accuracies were 88.95%, 90.2% and 93.64% respectively.There was no significant difference in diagnostic accuracy between conventional coronary angiography and 64-slice computed tomography in moderate （50% 70%） as well as severe （ 〉70%） stenosis （P〉0.05）.However, significant difference was found in mild （ 〈50%） stenosis （ P 〈0 .05 ） .Conclusion： Diagnostic accuracy of multi-detector computed coronary angiography is found to be higher in moderate and severe stenosis and can be used as an alternate to conventional coronary angiography （ CCA） .