定量多层螺旋CT冠状动脉成像与定量冠状动脉造影的对比研究

目的通过与同期定量冠状动脉造影(QCA)作对照,评价定量冠状动脉多层螺旋CT(QCT)成像对冠状动脉疾病的诊断价值。方法选择冠心病患者78例,利用QCA和QCT测量同一病变的最小管腔直径、最小管腔面积、参考直径、参考面积、靶病变长度、直径狭窄率、面积狭窄率等指标,比较2种方法结果的相关性及一致性。结果 78例患者中,存在明显冠状动脉病变62例(79.49%),QCT和QCA一致认为重度狭窄(>75%)的节段共为47段,其中右冠状动脉1 5段,前降支27段,回旋支5段。QCT和QCA测量的最小管腔面积、面积狭窄率比较,差异有统计学意义(P<0.05),2种测量最小管腔直径、参考直径、参考面积、靶病变长度和直径狭窄率的比较,差并均无统计学意义(P>0.05)。QCT和QCA测量最小管腔直径,靶病变长度,参考直径,参考面积,直径狭窄率一致性较好(0.5≤r_c≤0.85),最小管腔面积、面积狭窄率则一致性不佳(r_c<0.5)。结论 QCT检查能良好评价冠状动脉病变.可用于术前即可指导对经皮冠状动脉介入治疗中球囊和支架的选择。

Comparison between quantitative coronary CT and quantitative coronary angiography for detecting coronary artery stenosis

Objective To assess the diagnostic value of quantitative MSCT in detecting coronary artery disease as compared with quantitative coronary angiography(QCA).Methods Seventy-eight patients with coronary heart disease(CHD) were included in this study.Minimal lumen diameter (MLD),minimal lumen area(MLA),target lesion length(TLL),reference vascular diameter (RVD),reference vascular area(RVA),area stenosis(AS),diameter stenosis(DA) of the same lesion were measured with the two above methods.Results Sixty-two patients had significant lesions of coronary artery,47 segments had significant stenosis(>75%) detected by MSCT and QCA.There were no significant differences in the average values detected by MSCT and QCA (P>0.05),except for MLA and AS(P<0.05).There was positive correlation between MSCT and CAG results.There was good conformity for MLD,TLL,RVD,RVA,and DA(0.5≤r_c≤0.85) measured by MCST and QCA,but poor conformity for MLA and AS(r_c<0.5).Conclusions As a non-invasive method,MSCT can accurately evaluate MLD,MLA,TLL,RVD,RVA, AS,DA of the lesion and screen the patients with CHD,therefore it can be used for selecting balloon and stent in PCI therapy before the procedure.