100kVp条件下低流率双源CT冠脉造影价值研究

目的分析双源CT（DSCT）在低电压（100kV）、低流率对比剂（双低）条件下进行冠状动脉造影的质量,并与选择性冠状动脉造影（SCA）结果比对,探讨双低条件下DSCT对冠状动脉狭窄类疾病的诊断价值。方法分析25名冠心病疑似或确诊患者的DSCT冠状动脉造影图像,判别其影像质量。对比同样本患者的SCA,以血管狭窄≥50%为界,分析两者的相关性。结果根据美国心脏学会（AHA）-15冠状动脉分段法,分析双低条件下DSCT造影结果,25位患者共有339段血管显示优良,造影优良率达92.9%。以≥50%狭窄节段为界与金标准SCA比较,DSCT诊断的敏感度为91.5%,特异度为95%,阳性预测值83.2%,阴性预测值97.9%。结论以SCA为标准,双低条件下DSCT造影敏感度、特异度较高,可作为低辐射、高质量冠脉造影的有效临床方案。

Study the Value of Dual Resource CT Coronary Angiography in 100 kVp and Low Velocity

Objective To evaluate the diagnostic accuracy with Dual-source CT（DSCT）in low velocity of contrast agent and low radiation voltage compared with conventional select coronary angiography（SCA）.Methods25 Patients with suspected or known coronary artery disease（CAD）underwent both SCA and DSCT.Two experienced observers analyzed all CT scans for signs of CAD（stenosis of 0%,50%,50%-75%,≥75%,or100%）.Diagnostic accuracy of DSCT coronary angiography was compared with that of SCA.Results 339 coronary segments were perfectly revealed in 25 patients.92.9percent of coronary segment images was excellent.When the stenosis exceeded 50%,the sensitivity,specificity,negative predicting value and positive value of DSCT coronary angiography were 91.5%,95%,97.9%and 83.2%on a per-segment basis.Conclusion The result indicates DSCT coronary angiography provides high correlation for assessment of stenosis of coronary artery with conventional SCA.Therefore,DSCT coronary angiography can be used as routine method of diagnosis in stenosis of coronary artery.