Relation of coronary atherosclerosis and metabolic syndrome in asymptomatic subjects: evaluation with coronary CT angiography

To assess the relationship between metabolic syndrome (MetS) and coronary atherosclerosis using coronary CT angiography (CCTA) as the evaluation tool in asymptomatic cardiovascular disease (CVD) free subjects. The presence and extent of coronary atherosclerosis in 755 asymptomatic self-referred subjects were measured using CCTA. The relationships between coronary atherosclerosis, MetS, and other clinical factors were assessed. To further investigate the relationship between MetS and the presence and extent of coronary plaque, subjects were divided into 3 subgroups according to the number of metabolic factors (MF0, 1–2 or ≥3) and the number of coronary segments with plaque (segment involvement score: SIS0, 1, ≥2). MetS showed significant association with the presence of coronary plaque after adjustment for other clinical factors [odds radio (OR) 1.791 (1.159–2.775), P = 0.009]. Among metabolic components, abdominal obesity and high blood pressure were significantly associated with the presence of coronary plaque [OR 1.708 (1.189–2.455), P = 0.004; OR 1.677 (1.165–2.415), P = 0.005]. Coronary plaque was more frequently found in subgroups with a higher number of metabolic factors (32.4, 36.7 and 52.1 %). Higher SISs were also found in subjects with more MetS components (SIS1: 14.6, 16.2 and 27.2 %; SIS ≥ 2: 17, 19.7 and 23.7 %). In asymptomatic CVD free subjects, MetS and number of metabolic factors were related with an increased risk of the presence and the extent of coronary plaque. Abdominal obesity and high blood pressure were significantly associated with the presence of coronary plaque.     

Using clinical cardiovascular risk scores to predict coronary artery plaque severity and stenosis detected by CT coronary angiography in asymptomatic Chinese subjects

We aimed to determine whether the Framingham risk score (FRS), systematic coronary risk evaluation (SCORE), and Chinese multi-provincial cohort study (CMCS) could predict anatomic severity of coronary plaques. From January 2007 to October 2010, we performed a contrast-enhanced 64-slice or 256-slice multidetector computed tomography coronary angiography as part of a health check-up protocol in 806 asymptomatic subjects (70.5% male, 56 ± 9 year-old). Risk scores significantly correlated with calcium volume score, plaque stenosis score and plaque distribution score (P < 0.001). Of the 3 risk scores, the SCORE system showed the best correlation. Overall, 180 (22%) and 37 (5%) subjects were found to have stenosis of 50-69% and more than 70% in at-least one coronary artery segment, respectively. In the prediction of the presence of obstructive CAD (≥50% diameter stenosis), all risk scores had similar discrimination. In the prediction of severe CAD (≥70% diameter stenosis), FRS and CMCS had similar area under curves but SCORE discriminated better than FRS (P < 0.05). The optimal cutoff point to predict obstructive CAD was 9.54% for FRS, 1.05% for CMCS, and 0.95% for SCORE, whereas to predict severe CAD was 9.63, 1.05, 1.15% for FRS, CMCS, SCORE, respectively, with a sensitivity of 0.61–0.70 and a specificity of 0.55–0.66. Cardiovascular risk scores are associated with the severity and extent of coronary artery plaque. The stronger association might translate into a better discrimination using SCORE. These findings will aid in the appropriate selection or recalibration of the risk assessment system for cardiovascular disease screening.     

64层螺旋CT冠状动脉成像与冠状动脉造影对照研究

目的评价多层螺旋CT(MSCT)与冠状动脉造影对比,诊断冠状动脉中、重度狭窄(即管腔狭窄≥50%)的准确性和局限性。方法选择在1个月内先后行64层螺旋CT和冠状动脉造影检查的28例患者(其中男19例,女9例,年龄39~78岁,平均63.6岁)入组,分析两种检查的诊断结果。结果依节段计算MSCT的准确性,其灵敏度、特异度、阳性预测值和阴性预测值分别为46.5%、97.6%、86.8%和84.3%。若去除其中31个冠脉节段由于严重钙化而影响诊断的因素,则MSCT的诊断灵敏度、特异度、阳性预测值和阴性预测值分别为66.7%、98.6%、90.3%和93.6%。结论MSCT冠状动脉成像是一种简便易行、安全可靠、风险小的无创性检查,对诊断冠心病尤其针对筛选冠心病而言有较好的前景,但也有一定局限性。     

CT冠状动脉成像与冠状动脉导管造影评估冠状动脉钙化所致狭窄程度的一致性

目的 探讨CT冠状动脉成像(CTCA)与冠状动脉导管造影(ICA)评估冠状动脉钙化狭窄程度的一致性。方法 选取接受CTCA和ICA、且图像无明显伪影的45例冠状动脉钙化狭窄患者;分别测量其病灶处钙化CT值、血管CT值,计算二者的CT比值,即血管钙化CT比值=病灶周围钙化最高CT值/病灶周围血管近端无钙化层面的血管CT值。以所用患者血管钙化CT比值的总平均值为分界值,将病例分为A、B两组。分别比较两组中CTCA与ICA诊断冠状动脉钙化狭窄程度的一致性。结果 45例患者血管钙化CT比值的总平均值为3.04±0.89;A组血管钙化CT比值<3.04,共21例,CTCA与ICA对其狭窄程度评估的吻合率为95.24%(20/21),诊断一致性极好(Kappa=0.82,P<0.05);B组血管钙化CT比值≥3.04,共24例,CTCA与ICA对其狭窄程度评估的吻合率为37.50%(9/24),诊断一致性差(Kappa=0.172,P<0.05)。结论 当血管钙化CT比值<3.04时,采用CTCA评估冠状动脉钙化狭窄程度,与ICA的评估结果具有较好的一致性。     

Detection of coronary artery anomalies by dual-source CT coronary angiography

目的 应用实时三维超声心动图(RT-3DE)分析扩张型心肌病(DCM)患者左心室节段及整体运动同步性。方法 对27例DCM 患者(DCM 组)及22名正常人(对照组)行RT-3DE检查,采集三维图像,分析整体与各节段时间-容积曲线,获得左心室射血分数(LVEF)和左心室同步性参数,同步性参数包括心电图Q波起始点至收缩期左心室16节段、12节段、6节段最小容积时间间隔的标准差(Tmsv-16-SD、Tmsv-12-SD、Tmsv-6-SD)和最大时间差(Tmsv-16-Dif、Tmsv-12-Dif、Tmsv-6-Dif)及心率校正后的同步性参数(Tmsv-16-SD% RR、Tmsv-12-SD% RR、Tmsv-6-SD% RR、Tmsv-16-Dif% RR、Tmsv-12-Dif% RR、Tmsv-6-Dif% RR)。测量左心室17节段从心电图Q 波起始点至收缩期最小容积时间间隔(Tmsvr),计算左心室基底水平6个节段、中间水平6个节段和心尖水平4个节段达到收缩期最小容积时间的平均值(Tmsvr1-6、Tmsvr7-12、Tmsvr13-16)及其标准差(Tmsvr1-6-SD、Tmsvr7-12-SD、Tmsvr13-16-SD)。结果 DCM 组与对照组心肌对应节段Tmsvr差异无统计学意义。DCM 组及对照组组内17节段间Tmsvr差异无统计学意义。DCM 组及对照组对应水平Tmsvr1-6、Tmsvr7-12和Tmsvr13-16差异无统计学意义,而DCM 组Tmsvr1-6-SD、Tmsvr7-12-SD和Tmsvr13-16-SD均较对照组增大(P均<0.05)。与对照组相比,DCM 组Tmsv-16-SD% RR、Tmsv-12-SD% RR、Tmsv-6-SD% RR、Tmsv-16-Dif% RR、Tmsv-12-Dif% RR、Tmsv-6-Dif% RR增大(P均<0.05)。DCM 组RT-3DE所测LVEF与各整体同步性参数之间均呈负相关(LVEF 与Tmsv-16-SD% RR、Tmsv-12-SD% RR、Tmsv-6-SD% RR、Tmsv-16-Dif% RR、Tmsv-12-Dif%RR、Tmsv-6-Dif% RR的相关系数分别为-0.626、-0.455、-0.426、-0.646、-0.463、-0.455,P均<0.001)。DCM 组RT-3DE所测LVEF与左心室各水平达到收缩期最小容积时间平均值的标准差呈负相关(LVEF与Tmsvr1-6-SD、Tmsvr7-12-SD、Tmsvr13-16-SD的相关系数分别为-0.396、-0.357、-0.613,P均<0.05)。DCM 组各同步性参数与LVEF的多元回归方程中Tmsv-16-SD和Tmsv-12-SD% RR与LVEF存在显著回归关系(β=-1.703、1.140,P均<0.01)。结论RT-3DE能有效评价DCM 患者左心室运动同步性,DCM 患者左心室整体运动与正常人存在差异,左心室整体运动同步性是影响LVEF的重要因素。     

双源CT冠状动脉造影评价冠状动脉狭窄

目的 评价双源CT(DSCT)冠状动脉造影诊断冠状动脉狭窄的准确性.方法 收集104例临床疑诊或确诊冠心病并于30日内先后接受DSCT冠状动脉造影检查和导管法冠状动脉造影(CAG)患者,以CAG诊断结果作为金标准,分别评估DSCT诊断冠状动脉狭窄性病变(＜50％、≥500％和≥75％)的价值.结果 CAG显示1296段冠状动脉.DSCT可评估的冠状动脉为1217段,可评估率为93.90％(1217/1296);诊断＜500％、≥50％和≥75％狭窄的敏感度分别为79.12％ (144/182) 、84.73％ (172/203)和89.83％(106/118),特异度分别为97.33％(802/824) 、99.21％(1006/1014)和99.82％(1097/1099),阳性预测值为86.75％(144/166)、95.56％(172/180)和98.15％(106/108),阴性预测值为95.48％(802/840) 、97.01％(1006/1037)和98.92％(1097/1 109),准确率为94.04％(946/1006) 、96.80％ (1178/1217)和98.85％(1203/1217).钙化斑块是导致血管不可评估及误诊的主要原因.结论 DSCT冠状动脉造影判断冠状动脉狭窄程度的准确性较高,可作为临床筛查冠心病的较为可靠的方法.     

双源CT冠状动脉血管成像的临床应用

冠状动脉性心脏病是一种常见病、多发病.双源CT以极高时间分辨率和高空间分辨率的优势,可以不依赖心率进行冠状动脉数据采集,获得满意的影像质量,使临床适应范围更宽,诊断更加准确,真正满足了临床冠状动脉疾病检查的需要,无疑也是目前冠状动脉最好的无创检查方法.本文综述双源CT的基本特点和在冠状动脉血管成像中的临床应用.     

Prognostic value of coronary artery calcium score and coronary CT angiography in patients with intermediate risk of coronary artery disease

The aim of this study was to compare the prognostic value of coronary calcium scoring and coronary computed tomography (CT) angiography in assessing the cardiac risk and its temporal characteristics in patients at intermediate pre-test likelihood of coronary artery disease (CAD). Cardiac CT was performed in 326 patients at intermediate (15–85%) pre-test likelihood of CAD to evaluate calcium score and presence and severity of the disease. Patients were followed-up for the occurrence of major cardiac events (cardiac death, myocardial infarction, and unstable angina requiring revascularization). During follow-up (26 ± 12 months) 34 events occurred. Calcium score, extent of CAD, and plaque extent and distribution were higher (all P < 0.001) in patients with events than in those without. No patients with calcium score of 0 had events at follow-up. Calcium score (P < 0.001), number of segments with non-calcified or mixed plaque (P < 0.05), and segments-at-risk-score (P < 0.005) were independent predictors of events. Cardiac risk was greater for all time intervals and accelerated more over time with worsening of calcium score. In presence of coronary calcium, significant CAD further increased the probability of failure for all time intervals. Therefore, patients at intermediate CAD risk without coronary calcium do not need further evaluation with longer and higher-radiation-dose protocols, while in the presence of coronary calcium CT angiography is useful to further stratify patients.     

多层螺旋CT冠状动脉成像与冠状动脉造影对照

背景：许多初步研究结果表明，16层螺旋CT对冠状动脉狭窄的显示具有较高的准确性。 目的：通过与冠状动脉造影对比评价多层螺旋CT诊断冠状动脉中、重度狭窄的准确性和局限性。 设计、时间及地点：金标准对照观察的临床诊断实验，于2005—06／2006—03在首都医科大学宣武医院心脏科完成。 对象：选择2005—06／2006—03首都医科大学宣武医院心内科收治的1个月内先后行64层螺旋CT和冠状动脉造影检查的临床诊断或可疑冠状动脉硬化性心脏病患者28例。 方法：采用国际上通用的目测直径法，对选择性冠状动脉造影或多层螺旋CT显示冠状动脉狭窄进行定量评价。分别对28例患者的280个节段进行分析。 主要观察指标：多层螺旋CT冠状动脉成像对冠状动脉狭窄的真阳性、真阴性、假阳性、假阴性以及灵敏度、特异度、准确度、阳性预测值、阴性预测值。 结果：纳入的28例患者全部进入结果分析。依节段计算多层螺旋CT的准确性，其灵敏度、特异度、阳性预测值和阴性预测值分别为46．5％，97．6％，86．8％和84-3％。若去除其中31个冠状动脉节段由于严重钙化而影响诊断的因素，则多层螺旋CT的诊断灵敏度、特异度、阳性预测值和阴性预测分别为     

冠状动脉钙化多层螺旋 CT检查及与冠状动脉造影的对比研究

目的研究多层螺旋CT所见冠状动脉钙化与冠状动脉狭窄之间关系,并与冠状动脉造影进行对比.方法 23例临床怀疑或确诊冠心病患者(男17例,女6例,年龄31～74岁)均行 MSCT检查及冠状动脉造影.MSCT扫描采用心电门控触发成像,单次扫描时间为 0.32 s,层厚为2 mm×4 mm.将MSCT所见钙化与常规冠状动脉造影对比.结果 58支发现钙化的血管中,78%有冠状动脉狭窄 (>50% ), 47支造影证实冠状动脉狭窄 (>50% )的血管中,96%发现冠状动脉钙化.青年组与老年组相比,冠状动脉钙化预测冠心病的敏感性较低而特异性较高.结论多层螺旋CT检出冠状动脉钙化简便易行,可广泛用于临床预测及早期诊断冠心病.     

Assessment of image quality and radiation dose in prospective ECG-triggered coronary CT angiography compared with retrospective ECG-gated coronary CT angiography

We sought to determine the cut-off point of the average heart rate (HR) and HR differences in obtaining diagnostic image quality using prospective electrocardiographically-triggered (PT) coronary computed tomographic angiography (CCTA) and to compare image quality and radiation dose for CCTA obtained with PT CCTA and retrospective electrocardiographically-gated (RG) CCTA. A total of 178 patients who were referred for CCTA were enrolled in the study. Two independent radiologists evaluated subjective image quality. The non-diagnostic coronary segments were 32 of 1,226 segments (2.6%) for PT CCTA and 12 of 1,346 segments (0.9%) for RG CCTA (P < 0.001). The mean image quality scores for PT CCTA and RG CCTA were 3.82 ± 0.29 and 3.93 ± 0.14, respectively. The mean radiation dose of patients that underwent PT CCTA was 3.83 ± 0.84 mSv and RG CCTA 10.7 ± 2.70 mSv. For patients who underwent PT CCTA, image quality was inversely related to HR (56.5 ± 4.3 bpm; r = 0.38; P < 0.001) and HR differences (2.8 ± 2.7 bpm; r = 0.49; P < 0.001). With the use of receiver operator characteristic analysis, a cut-off HR of 57 bpm (58% sensitivity, 67% specificity) and HR difference of 6 bpm (93% sensitivity, 46% specificity) were the best threshold for the prediction of diagnostic image quality. In patients with a regular, low HR, PT CCTA offers diagnostic image quality and substantially reduces effective radiation compared with the use of RG CCTA with dose modulation.     

Demonstration of false-negative findings on CT hepatic angiography

False-negative findings on CT angiography (CTA) in two patients with hepatocellular carcinoma (HCC) were demonstrated. CTA images of one patient with an aberrant left hepatic artery branching from the left gastric artery and another patient whose right hepatic artery was occluded owing to an unknown cause failed to demonstrate HCCs. This report suggests one of the diagnostic pitfalls of CTA for diagnosis of liver tumors. Received: 1 August 1995/Accepted: 12 September 1995     

多层螺旋CT对冠状动脉支架通畅性的评价

目的 探讨多层螺旋CT冠状动脉成像评价冠状动脉支架通畅性的临床效果.方法 对26例冠状动脉支架植入术后患者的40枚支架行多层螺旋CT性心电门控增强扫描,所有患者均在CTA之后3个月内再次行CAG检查.评价支架的轴位,多平面重组（MPR） 图像及通过支架内腔中心的曲面重组（CPR） 图像,计算支架内管腔面积与支架标定的管腔面积的比值以评价支架内腔狭窄程度.CTA结果与CAG判定的结果相比较.结果 全部40枚支架腔内狭窄程度的评估,支架腔＞50%狭窄的敏感性和特异性分别为71.4%和100%,诊断支架腔＜50%狭窄的敏感性和特异性分别为77.8%和93.9%,诊断支架腔内无狭窄的敏感性和特异性分别为87.5%和100%.在一定条件下,16层与64层螺旋CT诊断冠状动脉支架管腔狭窄程度的结果间差异没有显著性（P＞0.05）.结论 以传统冠状动脉造影（CAG）为金标准,MSCT判断冠状动脉支架再狭窄病变中对于阴性病例及＞50%的严重病例具有较高的特异性.     

冠状动脉造影与多层螺旋CT冠脉成像在心肌桥诊断中的价值

目的：探讨多层螺旋CT冠脉成像（CCTA）与冠状动脉造影（CAG）在心肌桥（M B）诊断中的价值。方法：回顾性分析疑诊冠状动脉疾病的406例均进行CCTA和CAG检查者,两组采用双盲法CCTA和CAG分别独立阅片,由2名有经验的放射科医生与2名有经验的心内科介入医生采用单盲法阅片,经讨论后共同给出诊断。相互参照另一种检查结果后再次阅片,2次检出率,应用χ^2统计分析方法,判断2种方法发现M B有无差异。结果：双盲法CCTA发现M B 19例26段,CAG发现5例5段（P〈0.01）,差异有统计学意义。相互对照后再次评价,CCTA发现M B数量同前,CAG新发现3例,将新检出的3例患者行腺苷负荷核素心肌显像,相应节段心肌出现心肌低灌注,位置与CCTA一致,共检出8例,2种方法差异有统计学意义（P〈0.05）。结论：CCTA对M B和壁冠状动脉显示清晰,较CAG有更高的检出率,容易发现M B,有着特殊的临床诊断价值。     

Atherosclerotic pattern of coronary myocardial bridging assessed with CT coronary angiography

The aim of our study was to evaluate the atherosclerotic pattern of patients with coronary myocardial bridging (MB) by means of CT Coronary Angiography (CT-CA). 254 consecutive patients (166 male, mean age 58.6 ± 10.3) who underwent 64-slice CT-CA according to current clinical indications were reviewed for the presence of MB and concomitant segmental atherosclerotic pattern. Coronary plaques were assessed in all patients enrolled. 73 patients (29%) presented single (90%) or multiple (10%) MB, frequently (93%) localized in the mid-distal left anterior descending artery. The MB segment was always free of atherosclerosis. Segments proximal to the MB presented: no atherosclerotic disease (n = 37), positive remodeling (n = 23), <50% (n = 14), or >50% stenoses (n = 7). Distal segments presented a different atherosclerosis pattern (P < 0.0001): absence of disease (n = 73), no significant lesions (n = 8). No significant differences were found between segments proximal to MB and proximal coronary segments apart from left main trunk. Pattern of atherosclerotic lesions located in segments 6 and 7 significantly differs between patients with MB and patients without MB (P < 0.05). CT-CA is a reliable method to non-invasively demonstrate MB and related atherosclerotic pattern. CT-CA provides new insight regarding atherosclerosis distribution in segments close to MB.     

Dual-source CT coronary angiography without heart rate or rhythm control in comparison with conventional coronary angiography

To explore the value of dual-source CT angiography (DSCTA) in diagnosing coronary artery stenosis (CAS) without heart rate or rhythm control. Eighty-nine patients with different heart rates/rhythms underwent both DSCTA and conventional coronary angiography (CCA) in 1 week. The diagnostic quality of normal coronary arteries and stenosed segments using DSCTA and CCA were analyzed, respectively, with CCA as the gold standard. Kappa test was used to assess the intermodality agreement between DSCTA and CCA in grading CAS. The value of DSCTA in diagnosing CAS (>50% stenoses) were analyzed as well. The total evaluable rate of DSCTA in detecting coronary arteries was 98.8%. No significant difference between evaluable rates from different groups of heart rate (χ ² = 1.745, P > 0.05) was found. Sensitivity, specificity, positive and negative predictive values of DSCTA in detecting CAS and >50% stenoses were 97.9, 96.8, 89.5, 99.4 and 97.2, 95.5, 80.3, 99.4%, respectively; The inter-modality agreement between DSCTA and CCA in grading CAS was found to be excellent (k = 0.856, P < 0.01). DSCTA provides high accuracy and reliability for evaluation of CAS in a high suspected patient group without heart rate/rhythm control. It can be used as a powerful primary tool for the detection of CAS and a potential substitute of CCA.     

双源CT冠状动脉成像与常规冠状动脉造影诊断冠状动脉病变的对比分析

目的探讨双源CT冠状动脉成像(DSCTCA)对冠状动脉狭窄程度及复杂性冠状动脉病变的诊断价值。方法选择71例接受DSCTCA检查,提示至少有1支冠状动脉病变(CAL)患者,并于3周内行常规冠状动脉造影(CCA)。对比分析DSCTCA与CCA显示的冠状动脉狭窄程度及复杂性冠状动脉病变,包括分叉病变、慢性完全闭塞病变(choronic total occlusion,CTO)、开口病变、弥漫性长病变结果。结果 DSCTCA对每支冠状动脉及每例患者的冠状动脉病变程度的评价,与CCA比较相似,差异均无统计学意义(P均(0.05);DSCTCA检出95支冠状动脉有钙化,CCA仅发现12支冠状动脉有钙化,差异有统计学意义(χ2=79.327,P0.01);DSCTCA检出53支血管有弥漫性长病变,CCA仅检出32支,差异有统计学意义(χ2=6.101,P=0.014);DSCTCA检出61处分叉病变,按照Lefevre分型,Ⅰ型20处、Ⅱ型25处、Ⅲ型7处、Ⅳ型3处、Ⅳa型4处和Ⅳb型2处,与CCA对比,DSCTCA诊断分叉病变敏感度、特异度、阳性预测值、阴性预测值,以患者计算均为100.0%,以血管计算分别是100.0%、99.3%、90.2%、100.0%;DSCTCA检查11处慢性完全闭塞性病变、5处开口病变,与CCA比较,DSCTCA诊断CTO及开口病变的敏感度、特异度、阳性预测值、阴性预测值,以患者和血管计算均为100%。结论 DSCTCA能评价冠状动脉病变狭窄程度,对钙化病变、弥漫性长病变DSCTCA的诊断价值优于CCA,对分叉病变、CTO、开口病变的诊断与CCA有极好的一致性。     

多层螺旋CT冠脉成像与选择性冠脉造影初步探讨

目的评价多层螺旋CT(MSCT)诊断冠状动脉狭窄的可行性和准确性.方法35例临床拟诊冠心病患者行冠状动脉MSCT成像,同时接受选择性冠状动脉造影.分析MSCT图像质量,并与选择性冠状动脉造影相比较.结果以冠状动脉造影结果作为金标准,MSCT诊断狭窄≥50%的敏感度、特异度、阳性预测值、阴性预测值分别为79.4%、95.7%、83.1%、94.6%.结论MSCT能较准确诊断冠状动脉50%以上的狭窄,是无创性诊断冠状动脉狭窄的重要工具.     

双源CT冠状动脉成像评价冠状动脉狭窄

目的 评价双源CT冠状动脉成像(DSCTA)诊断冠状动脉狭窄的价值。方法 回顾性分析41例临床疑似冠心病或已经确诊的冠心病患者的DSCTA和CAG检查资料。以CAG结果为金标准,计算DSCTA诊断轻度(管腔狭窄＜50%)、中度(管腔狭窄50%~75%)、重度(管腔狭窄≥75%)冠状动脉狭窄及DSCTA诊断冠状动脉狭窄的总体敏感度、特异度、阳性预测值、阴性预测值及准确率。结果 41例患者共546个直径≥1.5 mm的冠状动脉节段中535个满足诊断要求,其余11个因钙化斑块遮蔽管腔而无法诊断。DSCTA诊断轻度、中度、重度冠状动脉狭窄敏感度、特异度、阳性预测值、阴性预测值及准确率分别为69.23%(36/52)、96.60%(341/353)、75.00%(36/48)、95.52%(341/357)、93.09%(377/405),68.42%(26/38)、99.42%(341/343)、92.86%(26/28)、96.60%(341/353)、96.33%(367/381),70.67%(53/75)、99.71%(341/342)、98.15%(53/54)、93.94%(341/363)、94.48%(394/417),诊断冠状动脉狭窄的总体敏感度、特异度、阳性预测值、阴性预测值及准确率分别为64.61%(115/178)、95.52%(341/357)、87.79%(115/131)、84.41%(341/404)、85.23%(456/535)。结论 作为一种无创性检查手段,DSCTA对评价冠状动脉狭窄程度具有较高的准确性。