螺旋CT在冠心病诊断中的应用价值及心率对其的影响

目的探讨16层螺旋CT（16-Slice Spiral CT，16-SCT）在冠心病诊断中的应用价值及心率对其的影响。方法45例患者随机分为A、B、C三组．使用倍他乐克及阿托品使心率分别控制在〈60次／分，60-70次／分，〉70次／分，均接受16-SCT检查，并与常规冠状动脉造影术（coronary angiography，CAG）对照。结幂A组中，16-SCT显示率为97．8％，评价中度狭窄的敏感度和特异度分别为92.3％、96．3％，高度狭窄的敏感度和特异度分别为100％、96．7％；B组中，16-SCT显示率为88．5％，评价中度狭窄的敏感度和特异度分别为84．6％、90．7％。高度狭窄的敏感度和特异度分别为90．9％、94．6％；C组中，16-SCT显示率为76．6％，评价中度狭窄的敏感度和特异度分别为52．0％、68名％。高度狭窄的敏感度和特异度分别为61．．5％、79．4％。与CAG比较，A、B两组中16-SCT对显示中度狭窄以上节段无显著性差异（P〉0．05），C组中16-SCT对显示中度狭窄以上节段有显著性差异（P〈0．05）。结论16-SCT冠状动脉成像质量与心率呈负相关，当心率控制在（70次／分时。16-SCT可代替CAG作为诊断冠心病的常规筛选检查。

Application value of 16-Slice Spiral CT to diagnose Coronary Artery Disease and the influence of Heart Rate on it

Objective To study the application value of 16-Slice Spiral CT(16-SCT) to diagnose Coronary Artery Disease and the Influence of Heart Rate on it. Methods 45 patients were assigned randomly to group A, B, C. The heart rate of the patients were controlled below 60bpm in group A, 60-70bpm in group B and over 70bpm in group C respectively by using metoprolol and atropine. All patients were checked by 16-SCT. The CT pictures of them were compared with convention coronary arteriongraphy (CAG). Results In group A, the detection rate was 97.8%, its sensitivity and specificity were 92.3%, 96.3% to middle stenosis, 100%, 96.7% to hard stenosis. In group B, the detection rate was 88.5%, sensitivity and specificity were 84.6%, 90.7% to middle stenosis, and 90.9%, 94.6% to hard stenosis. In the group C, detection rate was 76.6%, sensitivity and specificity were 52.0%, 68.8% to middle stenosis, 61.5%, 79.4% to hard stenosis. In group A and group B, the hard and middle stenosis segments can be shown by CAG as well as 16-SCT and there is not remarkable difference (p>0.05) between two examination methods. But in group C, there is significant difference between 16-SCT and CAG( p<0.05),The CAG demonstrate middle and hard stenosis much better than 16-SCT. Conclusions Image quality of 16-SCT coronary arteriongraphy was correlated negatively with heart rate. Repalcing CAG, 16-SCT can be routine examination to diagnose coronary artery disease when heart rate are lower than 70bpm.