64层螺旋CT冠状动脉血管成像的临床应用价值

目的评价64层螺旋cT用于诊断冠状动脉病变的临床价值。方法搜集35例患者64层螺旋cT冠状动脉血管成像的完整资料，并以近期实施的选择性冠状动脉造影（SCA）结果为金标准进行对比，以评价64层螺旋CT冠状动脉成像的应用价值。结果35例病例可用于评估的冠状动脉共计356个节段，成功率91．28％。其中SCA共显示73个节段冠脉有中、重度狭窄（≥50％），其结果与冠状动脉成像结果比较，对病变诊断的敏感性为90．7％，特异性为95．3％，准确性为94．7％，阳性预测值为92．9％，阴性预测值为97．6％；支架术后7例，共11段血管段上有支架；搭桥术后2例，共4支桥血管。结论64层螺旋cT冠状动脉血管成像作为一种无创的检查手段，在诊断冠状动脉病变中有较高的敏感性和特异性，适用于冠心病的早期筛查及冠状动脉搭桥和支架置入术前评价和术后复查的首选方法。

Clinical Value of 64-Slice Spiral CT Coronary Artery Imaging

Objective To study the clinical value of 64--slice spiral CT in coronary artery disease. Methods 35 patients,information of 64-slice spiral CT coronary artery imaging were compared with their results of selective coronary artery angiography to value clinical value of 64--slice spiral CT coronary artery imaging.Results 35 cases had 356 segments that could be used to evaluate, achievement ratio was 91.28%o among the total, selective coronary artery angiography showed 73 segments with middle to severe degree stenosis （≥ 50%）,and comparing with coronary artery imaging, for disease diagnosis its sensitivity was 90.7%,specificity was 95.3%, reliability was 94.7%,positive predictive value was 92.9%,negative predictive value was 97.6%;7 cases was after stentings,and stendings disposed in total 11 vessel segments; 2 cases was after coronary artery bypass,and 4 rami of bridge vesseles were showed.Conclusion As an atraumatic examination,64--sliee spiral CT coronary artery imaging has higher sensitivity and specificity,and it is preferred way to screening early coronary heart disease and to preoperative evaluation and postoperative re--examination of coronary artery bypass and stenting.