16层螺旋CT冠状动脉成像对男性和女性冠状动脉粥样硬化性心脏病的诊断价值

目的比较16层螺旋CT冠状动脉成像(16SCTCA)对男性和女性冠状动脉粥样硬化性心脏病(CAHD)的诊断价值。方法入选疑诊为CAHD的受检者共105例(男61例,女44例),对其分别行16SCTCA检查和选择性冠状动脉造影(CAG)检查,以CAG为诊断CAHD的金标准,评估检查结果。结果105例受检者中,16SCTCA共显示1 184个冠状动脉节段可进行评价。16SCTCA诊断男性受检者冠状动脉显著狭窄的敏感性为93.6%,特异性为95.1%,阳性预测值为73.9%,阴性预测值为99.0%,符合率为94.9%;诊断女性受检者冠状动脉显著狭窄的敏感性为84.1%,特异性为94.4%,阳性预测值为77.9%,阴性预测值为96.2%,符合率为92.4%;女性受检者接受16SCTCA检查诊断冠状动脉显著狭窄的敏感性和阴性预测值低于男性(P<0.05)。结论16SCTCA在显示冠状动脉病变时具有较高的诊断准确率,尤其适用于男性。

Comparison of Diagnostic value of 16-Slice Computed Tomography Coronary Angiography to detect coronary atherosclerotic heart disease in Women Versus Men

Objectives To compare the diagnostic value of 16-Slice Computed Tomography Coronary Angiography(16CTCA) to detect coronary atherosclerotic heart disease(CAHD) in women versus men.Methods Both 16SCTCA and selective coronary angiography(CAG) were performed in 105 patients(61males,44females).Results were compared with CAG findings which were regarded as gold standard for detecting CAHD.Compare the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 16CTCA to detect significant coronary stenosis in women versus men.Results 1184 coronary artery segments could be evaluated by 16SCTCA in all the 105 patients.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of16SCTCA to detect significant coronary stenosis were93.6%,95.1%,73.9%,99.0%,and 94.9% in men while the sensitivity,specificity,positive predict value,negative predict value and accuracy of 16SCTCA to detect significant coronary stenosis were 84.1%,94.4%,77.9%,96.2%,and 92.4% in women.The analysis demonstrated lower sensitivity and negative predictive value in women compared with men(P<0.05).Conclusions The 16SCTCA is a very valuable method in detecting CAHD.It maybe more valuable when it is performed in men.