64层螺旋CT在急性冠脉综合征中的临床应用

目的探讨多层螺旋CT（MSCT）冠脉造影（CA）对急性冠脉综合征（ACS）的临床诊断价值。方法对33例因胸痛而疑诊为ACS的患者行64层螺旋CT冠脉造影检查，并进行选择性冠状动脉造影（SAG）、心电图（ECG）检查。以SAG结果为“金标准”，比较其对ACS诊断的准确性。结果7例MSCT与SAG均排除冠脉狭窄病变。64层螺旋CT、ECG诊断中重度冠脉狭窄的敏感度分别为96．0％、88．0％；特异度为87．5％、37．5％；阳性预测值为96．0％、81．5％；阴性预测值为87．5％、50．0％。18例含有斑块，其中11例含软斑块，并进行了经皮冠状动脉腔内成形和支架植入术。结论64层螺旋CT冠脉造影对急性冠脉综合征患者是一种安全、可靠的无创性检查方法，并对内科介入治疗有指导价值。

Clinical application of 64-slice spiral CT coronary angiography in patients with acute coronary syndrome

Objective To assess the clinical value of multislice spiral CT coronary angiography in patients with acute coronary syndrome (ACS).Methods 64-slice spiral CT coronary angiography(MSCTCA),selective coronary angiography (SAG) and electrocardiogram (ECG) were all applied in 33 patients with suspected acute coronary syndrome (ACS) because of chest pain.The selective coronary angiography was selected as gold standard for detecting significant coronary artery stenosis and occlusions.Results The diagnosis sensitivity of 64-slice SCTCA,ECG was 96.0%,88.0%;the accuracy also in order was 87.5%,37.5%;the positive predicted value respectively was 96.0%,81.5%;the negative predicted value respectively was 87.5%,50.0% for finding a stenosis>50%.18 patients had plaques in coronary arteries,and 11 patients had plaques in the culprit coronary arteries.Conclusion As a minimally invasive examination,64-slice spiral CT is a safe and valuable methoed to the patients with acute coronary syndrome and enables to detect lumen obstruction>50% and vulnerable plaques in coronary arteries.