64排螺旋CT冠状动脉成像误诊分析

目的对照X线冠状动脉造影分析64排螺旋CT冠状动脉成像误诊原因。方法搜集140例患者64排螺旋CT冠状动脉成像（64DCTCA）完整资料,以其近期实施的X线冠状动脉造影（CAG）结果为金标准对比,对于两种检查结果中不同的部分进行分析。结果本组64DCTCA显示1343支冠状动脉,不同部位的Ⅲ级血管冠状动脉成像质量无显著差异（χ^2检验,P〉0.05）。在Ⅰ、Ⅱ级血管中,79支两项检查结果不一致,其中64DCTCA假阳性28支,假阴性14支,10支病变程度评估过重,27支评估过轻。各组血管间总体存在显著差异（χ^2检验,P〈0.01）;对冠状动脉主干与分支的误诊率之间存在显著差异（χ^2检验,P〈0.01）,而冠状动脉主干LAD,LCX和RCA病变显示无显著差异（χ^2检验,P〉0.05）。结论完善的检查前准备是保障64DCTCA重组优质冠状动脉图像的前提,良好的图像后处理有助于避免误诊。

Analyzing misdiagnosis of 64-detector computed tomography coronary angiography

Objective To analyze the misdiagnosis of 64-detect computed tomography coronary angiography in contrast to conventional coronary angiography and want to avoidance.Methods Coronary arteries of 140 patients were assessed with 64DCTCA comparing with CAG implemented recently.Results A total of 1343 coronary arteries were showed with 64DCTCA,among which 50 were excluded for poor quality,and 79 misdiagnosis were found in the rest,including 28 false positive,14 false negative,11 over-diagnosis and 27 under-diagnosis.Further statistical analysis using χ^2 test showed obvious differences of misdiagnosis among different subranches of coronary arteries as well as main branches（LAD,LCX and RCA）and subbranches,but no obvious differences existed among major bronches.Conclusion Perfect preparation before examination can increase imaging quality of 64DCTCA;proper post-processing of image is helpful to avoide misdiagnose.