冠状动脉狭窄的16层螺旋CT冠状动脉CTA与冠状动脉造影对照研究

目的 以选择性冠状动脉造影(selective X-ray coronary angiography,SCA)为标准,评价16层螺旋CT(16-slice spiral compated tomography,16-SCT)冠状动脉CT血管成像(coronary angiographywith CT,CTA)诊断冠状动脉狭窄的价值.方法 21例患者行16-SCT冠状动脉CTA检查后,回顾性重建心电门控轴位图像,并采用容积成像、多平面重建、曲面重建、最大密度投影等后处理方法,对所有冠状动脉及其分支进行重建,统计可供临床评价的管径＞2.0mm的冠状动脉段,以选择性冠状动脉造影作对照,对比分析其诊断各类冠状动脉狭窄的敏感性、特异性和准确性.结果 16-SCT冠状动脉CTA诊断冠状动脉重度狭窄的敏感性为100%,特异性95%,阳性预测值90%,阴性预测值100%;诊断中度狭窄的敏感性为92.9%,特异性75%,阳性预测值72.2%,阴性预测值93.8%;诊断轻度狭窄的敏感性位81.8%,特异性35.7%,阳性预测值52.9%,阴性预测值71.4%.结论 16-SCT冠状动脉CTA可获得较好的图像质量用于诊断冠状动脉狭窄,是一种无创、可靠、有效的冠状动脉CTA方法,可作为一种诊断冠状动脉有无狭窄的非创伤性方法用于临床.

Comparative study between coronary angiography with 16-slice spiral computed tomography and selective X-ray coronary angiography in coronary artery stenosis

Objective To evaluate the diagnostic value of 16-slice spiral computed tomography(16-SCT) for coronary artery stenosis by compared with selective X-ray coronary angiography(SCA).Methods The images of coronary artery on 16-SCT were obtained in 21 cases.The techniques of retrospective ECG-gating,volume rendering technique,multiple planar reconstruction,curved planar reconstruction and maximum intensity projection were applied.The coronary artery segments and their branches were reconstructed.The blood vessels with caliber >2.0mm were counted.The sensitivity,specificity and accuracy of 16-SCT for examination were analysized as compared with SCA.Results The sensitivity,specificity,positive predictive value and negative predictive value of 16-SCT for coronary angiography in diagnosing severe coronary stenosis were 100%,95%,90%,100%,for moderate coronary stenosis were 92.9%,75%,72.2%,93.8%,for mild coronary stenosis were 81.8%,35.7%,52.9% and 71.4% respectively.Conclusion The 16-SCT for coronary angiography can obtain high quality images for the diagnosis of coronary artery stenosis.It is a noninvasive,reliable and effective method for clinical application to diagnoses the severity of coronary artery stenoses.