64排螺旋CT冠脉成像在冠心病诊断中的临床价值分析

目的:分析64排螺旋CT冠脉成像在冠心病诊断中的临床价值.方法:将120例病理试验证实为冠心病的患者作为研究对象,所有患者均采用64排螺旋CT冠脉成像和冠状动脉造影进行诊断,比较两种诊断方法的敏感性、特异性、阳性预测率及阴性预测率.结果:以冠状动脉造影的诊断结果为金标准,64排螺旋CT的诊断敏感性为95.77％、特异性为96.47％、阳性预测率为93.15％、阴性预测率为97.85％.结论:冠心病患者采用64排螺旋CT冠脉成像诊断具有较高的诊断敏感性、特异性、阳性预测率及阴性预测率,值得推广.     

64层螺旋CT冠状动脉成像与冠状动脉造影的对比研究

目的评价64层螺旋CT冠状动脉成像诊断冠状动脉狭窄的准确性。方法 50例患者先后进行64层螺旋CT冠状动脉成像和冠状动脉造影检查,以冠状动脉造影为诊断冠状动脉疾病的"金标准",比较CT冠状动脉成像的符合率,评价64层螺旋CT冠状动脉成像诊断冠心病的准确性。结果 64层螺旋CT冠状动脉成像评价冠状动脉狭窄程度大于或等于50%的敏感性为98.6%,诊断狭窄程度小于50%的敏感性为87.0%,诊断冠状动脉狭窄的特异性为92.5%,阴性预测值为97.7%。结论 64层螺旋CT冠脉成像诊断冠状动脉狭窄有很高的准确率。     

64层螺旋CT冠状动脉成像与冠状动脉造影的对比研究

目的 评价64层螺旋CT冠状动脉造影对冠状动脉疾病的临床诊断价值.方法 59例临床诊断或可疑冠心病患者行64层螺旋CT冠状动脉成像检查,并以冠状动脉造影结果作为对照,分段评价结果,冠状动脉狭窄≥50%为阳性病变.分析64层螺旋CT冠状动脉血管成像(CTA)诊断冠状动脉狭窄的敏感性、特异性、阳性预测值及阴性预测值.结果 共评价741段冠状动脉,64层螺旋CT冠状动脉血管成像用于诊断冠心病的敏感性、特异性、阳性预测值、阴性预测值分别为58.8%、97.7%、76.9%、94.8%.结论 64层螺旋CT冠状动脉血管成像有较高的诊断准确性,可以作为评价冠状动脉狭窄的一种无创检查方法.     

西门子128层螺旋CT诊断冠状动脉狭窄的研究

目的探讨西门子128层螺旋CT冠状动脉成像（CTA）对诊断冠状动脉狭窄的价值。方法收集来我院就诊的疑似冠状动脉狭窄患者36例,均进行128层螺旋CT冠状动脉造影检查和DSA选择性冠状动脉造影检查,观察两种检查方法中冠状动脉狭窄的影像学表现和诊断价值,并与64层以下冠状动脉CTA进行对照。结果 36例冠状动脉狭窄患者的两种检查结果,经统计学分析,西门子128层螺旋CT对冠状动脉狭窄的敏感性为98.08%、特异性为95.69%、准确性为96.43%。与64层以下螺旋CT比较,对患者心率、屏气等方面的要求更加宽松。结论西门子128层螺旋CT对冠状动脉狭窄的诊断价值高,方法简单、快速准确、无创伤,患者易接受,可作为疑似冠状动脉狭窄患者的首选检查手段。     

64层螺旋CT对冠状动脉粥样硬化血管狭窄的评价

目的:探讨64层螺旋CT对冠状动脉粥样硬化各种程度血管狭窄的评估价值.方法:120例患者行64层螺旋CT血管造影(CTA)检查评价冠状动脉各段的狭窄程度,并与冠状动脉血管造影(CAG)比较,统计64层螺旋CTA诊断冠状动脉各种程度狭窄的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV).结果:64层螺旋CTA评...     

64排螺旋CT冠脉成像与选择性冠脉造影的对照分析

目的：探讨64排螺旋CT冠脉成像对冠状动脉评价的价值。方法：回顾分析2011-01～2012-05在本院既进行64排螺旋CT冠脉成像检查又行冠脉造影术的46例患者的影像学资料,将64排CT冠脉成像结果与冠脉造影结果进行比较,评价其敏感性和特异性。结果：64排螺旋CT冠脉成像判断血管≥50%狭窄的敏感性为95.8%,特异性为98.2%。结论：64排螺旋CT冠脉成像对冠心病的诊断有很高的敏感性和特异性,具有很高的临床应用价值。     

冠状动脉多层螺旋CT成像与常规冠脉造影对照研究

目的：探讨16层螺旋CT用于诊断冠状动脉粥样硬化性心脏病(冠心病)的价值。资料与方法：对230例临床可疑冠心病患者进行16层螺旋CT心电门控平扫及增强扫描。用平扫图像行钙化积分测定，用增强图像行二维及三维重建，其中40例患者有常规冠状动脉造影作对照。以常规造影为“金标准”，得出16层螺旋CT冠状动脉CT血管造影(CTA)诊断各类冠状动脉狭窄的敏感性、特异性和准确性。结果：16层螺旋CT冠状动脉CTA用于诊断冠状动脉轻度狭窄的敏感性为95.2％，特异性为90.2％；诊断中度以上狭窄的敏感性为100％，特异性为97.3％。结论：16层螺旋CT冠状动脉CTA是一种无创、简便、优良的冠状动脉成像方法，高质量的CTA图像可作为一种诊断冠心病的可靠手段用于临床。     

64MDCT冠状动脉成像在冠心病诊断中的应用价值

目的探讨64层螺旋CT冠状动脉成像在冠心病诊断中的应用价值。方法随机选择我院2010年10月～2011年12月46例由于胸痛、胸闷就诊的患者,分别给予64层螺旋CT冠状动脉成像与选择性冠状动脉造影,以选择性冠状动脉造影检查的结果为“金标准”,分析64层螺旋CT冠状动脉成像在冠心病诊断中的敏感性、特异性及准确率。结果MDCTCA共检查节段586个,直径在1．5mm以上有504个,检出狭窄程度≥50％的28例,漏诊1例,误诊2例。与冠状动脉造影检查结果相比,64层螺旋CT冠状动脉成像检查的敏感性为96．3％（26／27例）,特异性为89．5％（17／19例）,准确性为93．5％（43／46例）,阳性预测值为92．9％（26／28）,阴性预测值为94．4％（17／18）,差异无统计学意义（P〉0．05）。结论64层螺旋CTCA具有无创、安全、经济且操作简便的优点,对冠状动脉病变诊断具有良好的敏感度和特异性,是一种可广泛应用于冠心病的筛选和诊断的检查方法。     

64层螺旋CT冠状动脉成像临床应用

目的：探讨64层螺旋CT（MSCT）冠状动脉成像方法显示冠状动脉狭窄的能力及可靠性。方法：对26例临床怀疑冠心病的患者行心脏冠状动脉CT成像（CTA）并与常规冠状动脉造影（CAG）结果进行比较分析。结果：以冠状动脉血管造影（CAG）为金标准,冠状动脉CTA影像判断血流动力学相关性冠状动脉狭窄（≥50%）的敏感度0.933、特异度0.974、准确度0.968、阳性预测值0.857、阴性预测值0.989。结论：64层螺旋CT冠状动脉成像是一种无创、简便、优良的冠状动脉成像方法,可作为冠状动脉粥样硬化的筛选手段及冠状动脉术后复查的首选方法。     

64排螺旋CT对冠心病的诊断价值

目的研究64排螺旋CT冠状动脉成像对冠状动脉疾病的诊断价值。方法搜集128例可疑或已确诊为冠心病的患者进行64排螺旋CT扫描和常规冠状动脉造影,然后对2种检查方法的结果进行对比分析。结果128例患者共有1920个冠状动脉节段可用于评价,结果显示64排螺旋CT诊断冠状动脉病变的敏感性为92%,特异性为94%,阳性预测值为82%,阴性预测值为96%。结论64排螺旋CT对冠心病的诊断及病变程度的评估具有较高的准确性、特异性和敏感性。     

Intraindividual comparison of 3D coronary MR angiography and coronary CT angiography

RATIONALE AND OBJECTIVES: To compare the diagnostic value of magnetic resonance (MR) and computed tomography (CT) for the detection of coronary artery disease (CAD) with special regard to calcifications. MATERIALS AND METHODS: Twenty-seven patients with known CAD were examined with a targeted, navigator-gated, free-breathing, steady-state free precession MR angiography sequence (repetition time = 5.6 milliseconds, echo time = 2.8 milliseconds, flip angle 110 degrees ) and 16-slice coronary CT angiography. Segment-based sensitivity, specificity, and accuracy for the detection of stenoses larger than 50% were determined as defined by the gold standard catheter coronary angiography along with the subjective image quality (Grade 1-4). The degree of calcifications in each segment was quantified using a standard calcium scoring tool. RESULTS: Of 115 possible segments, 7% had to be excluded in MR imaging because of poor image quality. In CT, 3% were nondiagnostic because of image quality and 15% were not evaluable because of calcifications. Values for the detection of relevant coronary artery stenoses in the evaluated segments were: sensitivity: MR imaging 85% versus CT 96%; specificity: 88% versus 96%; accuracy: 87% versus. 96%. Average subjective image quality was 1.8 for MR imaging and 1.6 for CT. Of the 15% of segments that had to be excluded from CT evaluation because of calcifications, MR imaging provided the correct diagnosis segments in 67%. CONCLUSIONS: CT provided a better image quality with superior accuracy for the detection of CAD. Despite its overall inferiority, MR imaging proved to be helpful method in interpreting coronary stenosis in severely calcified segments.     

冠状动脉CT检查的辐射剂量

众所周知,基于X线成像的CT检查伴随着低剂量电离辐射.尽管这种剂量水平的电离辐射不会产生确定性生物学效应,但是低剂量辐射的随机性效应没有阈值,且发生几率与剂量成正比.这种效应的发生主要是由于X线可以导致DNA链的断裂和碱基的破坏[1].     

64-Slice CT coronary angiography versus conventional coronary angiography: activity-based cost analysis

Purpose

This study was done to analyse the costs of 64-slice computed tomography (CT) coronary angiography and conventional coronary angiography and determine the costeffectiveness of the two modalities.

Materials and methods

Detailed activity-based cost analyses of the two modalities were carried out at the departments of radiology and cardiology of a teaching hospital. The differential costs (equipment, variable, personnel), common costs and external costs were estimated. Finally, the full costs of the two procedures were obtained; the full cost of conventional coronary angiography also considered the cost of 1 day in hospital. The cost-effectiveness of the two procedures at different levels of pretest likelihood of coronary artery disease (CAD) was estimated.

Results

The costs of multidetector CT (MDCT) coronary angiography were as follows: differential cost 222.23 €, common cost 5.50 €, external cost 2.30 € and full cost 230.03 €. The costs of conventional coronary angiography were: differential cost 366.18 €, common cost 0.50 €, external cost 9.20 €, hospitalisation cost 1,652 € and full cost 2,027.88 €. Cost-effectiveness analysis showed that the cost per correctly identified CAD patient decreased exponentially with increasing pretest likelihoods of CAD. MDCT coronary angiography was more cost effective than conventional coronary angiography up to a pretest likelihood of 86%.

Conclusions

MDCT coronary angiography has far lower costs than conventional coronary angiography, and its costeffectiveness is better in the large majority of patients.     

冠状动脉CT血管成像低辐射剂量策略

CT冠状动脉成像已经成为临床评价冠状动脉重要的无创性检查方法.综述前瞻性心电门控、迭代重建算法、低kV技术以及心脏CT低剂量扫描技术的优势和不足 推荐在临床上根据CT机型、病人的体质量指数、心率变异联合应用多种降低辐射剂量的方法,并针对每例病人制定个性化的扫描方案,以便在影像信息满足诊断要求的同时,尽可能降低辐射剂量.     

双源CT冠脉成像在冠脉狭窄诊断中的价值

价节段达到94.98%(625/658),图像优良率95.52%(597/625).DSCT诊断冠状动脉狭窄的敏感性、特异性、阳性预测值及阴性预测值分别为91.8%、98.3%、94.4%、97.5%,其中对左主干、左前降支及右冠状动脉的敏感性及特异性达到95%,对角支、左回旋支分支及有冠状动脉远端的诊断敏感性有所下降,分别为86.0%、71.4%、76.9%.结论 在不控制心率的情况下,DSCT诊断冠脉狭窄安全可靠,可广泛用于冠心病患者的筛查、冠状动脉手术/支架术前评估及术后随访.     

Contrast-enhanced 64-section coronary multidetector CT angiography versus conventional coronary angiography for stent assessment

PURPOSE: To prospectively evaluate the accuracy of 64-section computed tomography (CT) for diagnosis of stent restenosis, by using conventional coronary angiography as the reference standard. MATERIALS AND METHODS: The ethics committee granted permission for the study; patients gave written consent. Contrast material-enhanced coronary CT angiography was performed in 53 patients (45 men, eight women; mean age, 54 years +/- 9 [standard deviation]) suspected of having stent restenosis. Coronary CT angiographic findings were compared with conventional coronary angiographic findings. Two physicians analyzed coronary CT angiographic data sets with multiplanar reformatted images and three-dimensional reformations by using a volume-rendering technique and looked for stent detectability, low-attenuation in-stent filling defects, and grades of restenosis. Conventional coronary angiographic results were interpreted by one of several observers in consensus for stent restenosis; they were blinded to coronary CT angiographic data. Statistical software and general estimating equations were used for data analysis. RESULTS: One hundred ten stents were identified in 53 patients. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of coronary CT angiography in detection of in-stent restenosis were 96.9%, 88.0%, 77.5%, 98.5%, and 91%, respectively. Coronary CT angiography depicted in-stent low-attenuation filling defects with an accuracy of 91% and negative predictive value of 98.5% (95% confidence interval: 90.9, 99.9). Coronary CT angiography depicted the status of 97 of 107 stents. There was no significant difference between in-stent lumen visibility and stent diameter (P = .104). Coronary CT angiography helped diagnose 15 of 18 stent restenoses with less than 50% narrowing, five of five stent restenoses with 50%-74% narrowing, and nine of nine (100%) stent restenoses with 75% or greater narrowing or total occlusion of the stent lumen. CONCLUSION: Coronary CT angiography can depict in-stent low-attenuation filling defects, which appear to be a reliable sign of stent restenosis, and 64-section CT depicts such defects with a high degree of accuracy.     

Current status of coronary multislice CT angiography

Multislice computed tomography (MSCT) is an emerging technique which has an enormous potential to improve the current practice of coronary artery imaging. This article reviews the current status of coronary MSCT angiography (MSCTA) with emphasis on the imaging techniques and clinical utilities of 16-slice CTA. Results and experiences gained from coronary MSCTA in the past few years have taught us that accurate diagnosis of coronary artery disease relies on good technical studies and can be achieved by optimizing image parameters including image timing and image reconstruction ECG-trigger delay. Current clinical applications of coronary MSCTA include: quantitative assessment of coronary artery stenosis, characterization of coronary atherosclerotic plaques, and follow-up of coronary artery stent and bypass graft. Furthermore, MSCT has brought an increasing awareness to the amount of radiation used in CT. This has prompted CT researchers and manufacturers to improve various techniques and develop new strategies to reduce radiation dose. It is anticipated that MSCT will become a sensitive and accurate tool for detecting coronary artery disease and monitoring outcomes after treatment for coronary artery disease.