320排CT冠状动脉成像与经导管冠状动脉造影诊断冠脉狭窄的对比分析

目的 通过对比320排CT冠状动脉成像术（CTA）与经导管冠状动脉造影（CAG）的结果,探讨其评估冠脉狭窄性病变的价值.方法 搜集100例患者的320排CTA的完整资料,以冠状动脉造影（CAG）的结果作为金标准进行对比,评价冠状动脉不同节段病变诊断的一致性及对冠脉狭窄程度诊断的差异性.结果 100例患者中冠状动脉直径≥2mm共有1 423个节段,在CTA检查中能够满足诊断要求的共有1 269个节段.320排CTA显示轻度狭窄（管腔内径减少＜50％）的敏感性、特异性、阳性预测值、阴性预测值分别为97.1％、84.4％、59.3％、94.4％,中度狭窄组（≥50％）的敏感性、特异性、阳性预测值、阴性预测值分别为87.4％、94.6％、75.2％、84.6％,重度狭窄组（≥75％）的敏感性、特异性、阳性预测值、阴性预测值分别为79.7％、83.6％、82.9％、92.8％,与CAG结果对比,320排CTA对轻、中度狭窄的敏感性、特异性的评价均较高.结论 320排冠状动脉成像术是诊断冠心病的一种安全、可靠的检查方法,对冠脉轻中度狭窄的敏感性高于CAG,对中重度狭窄的特异性较高.

Comparative study of 320-slice muitidetecor CT coronary angiography and conventional coronary angiography in the diagnosis of coronary artery stenosis

Objective To evaluate the accuracy of 320-slice multidetecor CT coronary angiography （CTA）and conventional coronary angiography （CAG） in diagnosis of coronary artery stenosis.Methods The 320-slice CTA data of1 00 patients with known or suspected coronary artery diseases （CAD） was collected and compared with that of selective coronary angiography （CAG）.Evaluation had been done concerning the 320-slice CT for detecting the stenosis of the variant branches and segments of the coronary arterys,and variants for diagnosis degree of stenosis.Results In the 100 patients,the coronary artery diameter was no less than 2 mm and there were a total of 1 423 segments,of which 1 269 meet the requirements in CTA.The sensitivity,specificity,false positive and false negatives values of CTA were 97.1％,84.4％,59.3％,94.4％ for mild stenosis （decrease of lumen diameter＜50％）,87.4％,94.6％,75.2％,84.6 for moderate stenosis （decrease of lumen diameter ≥ 50％）,79.7％,83.6％,82.9％,92.8％ for severe stenosis （decrease of lumen diameter≥75％）,respectively.In contrast to the CAG results,320-slice CTA showed higher sensitivity and specificity for mild and moderate stenosis.Conclusion 320-slice multidetecor CT coronary angiography is a safe and reliable method in the diagnosis of coronary heart diseases,with higher sensitivity than conventional coronary angiography （CAG） for mild stenosis and higher specificity for moderately severe stenosis.