CT冠状动脉成像在冠心病诊断中的应用价值研究

目的观察冠心病患者应用CT冠状动脉成像检查的临床诊断价值。方法 80例疑似冠心病患者,均进行CT冠状动脉成像以及冠状动脉造影检查。观察CT冠状动脉成像检查冠状动脉节段情况,以冠状动脉造影检查结果为金标准,分析CT冠状动脉成像检查在冠心病诊断中的诊断效能。结果 80例疑似患者中49例确诊为冠心病, 31例确诊为其他疾病。经CT冠状动脉成像检查发现冠状动脉节段765个,无明显异常节段650个,狭窄节段115个,其中31个节段为Ⅰ级狭窄, 46个节段为Ⅱ级狭窄, 38个节段为Ⅲ级狭窄。冠状动脉造影检查显示, 602个无明显异常节段诊断准确,Ⅰ级狭窄节段中23个诊断准确,Ⅱ级狭窄节段中40个诊断准确,Ⅲ级狭窄节段中32个诊断准确。CT冠状动脉成像诊断准确率为91.1%(697/765)。以冠状动脉造影检查结果为金标准, CT冠状动脉成像检查的灵敏度为91.8%(45/49)、特异度为93.5%(29/31),阳性预测值为95.7%(45/47),阴性预测值为87.9%(29/33)。结论对于收治的疑似冠心病患者应用CT冠状动脉成像检查能够较好的确诊疾病,对于冠状动脉的异变情况也有良好的指导价值。

Study the value of CT coronary artery imaging in the diagnosis of coronary heart disease

Objective To observe the clinical value of CT coronary artery imaging in the diagnosis of coronary heart disease. Methods 80 patients with suspected coronary heart disease were all detected by CT coronary angiography and coronary arteriongraphy. The segment condition of coronary artery by CT coronary angiography was observed. The diagnostic efficacy of CT coronary angiography for coronary heart disease was analyzed with coronary arteriongraphy as the gold standard. Results Of the 80 patients, 49 cases were diagnosed as coronary heart disease and 31 cases as other diseases. CT coronary angiography revealed 765 segments, of which 650 segments were normal, and 115 segments were stenosis, of which 31 segments were grade Ⅰ stenosis, 46 segments were grade Ⅱ stenosis, 38 segment was grade Ⅲ stenosis. According to coronary stenosis, 602 normal segments were correctly diagnosed, 23 segments of the grade Ⅰ stenosis were correctly diagnosed, 40 segments of grade Ⅱ stenosis were correctly diagnosed, and 32 segments of the grade Ⅲ stenosis were correctly diagnosed. The diagnostic accuracy of CT diagnosis was 91.1%(697/765). With coronary arteriongraphy results as the gold standard, the sensitivity of CT coronary angiography was 91.8%(45/49), the specificity was 93.5%(29/31), the positive predictive value was 95.7%(45/47), and negative predictive value was 87.9%(972/765). Conclusion CT coronary angiography shows high accuracy for patients with suspected coronary artery disease, and has good guiding value for coronary artery anomalies.