CTA在不同冠心病亚组中的诊断价值

目的评价CT冠状动脉成像（CTA）在不同冠心病亚组中的诊断价值。方法分别利用CTA（采用64层螺旋CT）与冠状动脉造影（CAG）对冠状动脉狭窄程度与冠脉内斑块性质进行对比分析，评价CTA与CAG的诊断符合率，并探讨稳定型心绞痛、不稳定型心绞痛、非ST段抬高性心肌梗死的斑块性质差异及临床意义。结果与CAG相比，CTA在显示冠状动脉病变的敏感性为96．96％，特异性为93．76％，假阴性率3．04％，假阳性率为6．24％，阳性预测值90．25％，阴性预测值为98．11％；以CAG为标准，CTA在显示冠脉斑块的整体符合率为85％；稳定型心绞痛（SAP）、不稳定型心绞痛（UAP）、非sT段抬高性心肌梗死（NSTEMI）的钙化斑块比例顺次降低，而混合斑块与软斑块比例顺次升高。结论CTA与CAG的诊断符合率较高，可用于诊断冠脉病变，并可对冠脉斑块性质作出初步诊断。

Diagnostic value of CT coronary angiography in different subgroups of coronary heart disease

Objective To review the diagnostic value of CT coronary angiography(CTA) in different subgroups of coronary heart disease.Methods The stenosis degree and plaque quality were analyzed by applying CTA(64-layer spiral CT) and coronary angiography(CAG),the diagnose coincidence rates of CTA and CAG were reviewed,and the difference in plaque quality of stable angina pectoris(SAP),unstable angina pectoris(UAP),non-ST-segment elevation myocardial infarction(NSTEMI) and clinical significance were investigated.Results When CAG was taken as the standard,the sensitivity of CTA to coronary artery lesions was 96.96%,false-negative rate was 3.04%,specificity was 93.76%,false-positive rate was 6.24%,positive predictive value was 90.25% and negative predictive value was 98.11%.When CAG was taken as the standard,the total coincidence rate of CTA for diagnosing plaques was 85%.The proportion of calcified plaques decreased and the proportions of mixed plaques and soft plaques increased in the order of SAP,UAP and NSTEMI.Conclusion The diagnose coincidence rates of CTA and CAG were higher,which can be used in the diagnosis of coronary artery lesions and plaque quality.