双源CT冠状动脉成像在飞行人员冠心病诊断中的价值

目的 探讨双源CT冠状动脉成像在飞行人员冠心病诊断中的临床应用价值.方法对10名临床怀疑冠心病的飞行人员患者行双源CT冠状动脉成像（computed tomography coronary angiography,CTCA）检查和常规X线冠状动脉血管造影（conventional coronary angiography,CCA）检查,以CCA为金标准比较分析CTCA诊断冠状动脉狭窄的敏感性、特异性及准确性.结果 10例飞行人员患者均成功完成了双源CTCA与CCA 检查,双源CTCA图像优良率为96.3%.CTCA发现不同程度冠状动脉狭窄和斑块形成7例,其中2例同时存在前降支心肌桥;冠状动脉-肺动脉瘘1例;冠状动脉正常2例.7例患者的CTCA图像上15个冠状动脉节段有不同程度狭窄,以CCA为金标准,双源CTCA诊断冠状动脉有狭窄的敏感性、特异性及准确率分别为100.0%、98.2%、98.4%;诊断冠状动脉中度及中度以上狭窄的敏感性、特异性及准确率分别为80.0%、99.2%、98.4%.双源CTCA与CCA显示冠状动脉节段病变的能力无统计学差异（χ2=0.50,P=0.4795）.结论 双源CTCA作为一种无创检查方法,能够准确地评估飞行人员冠状动脉狭窄程度和冠状动脉管壁斑块情况,并能显示冠状动脉先天变异等,对于安全可靠地诊断飞行人员冠心病具有较高的应用价值.

Clinical application value of dual-source CT coronary angiography in the diagnosis of coronary artery disease in flying personnel

Objective To explore the clinical value of dual-source CT coronary angiography (CTCA) in the diagnosis of coronary artery disease (CAD) in flying personnel. Methods Ten flying personnel, who were suspected CAD, underwent both CTCA and conventional coronary angiography (CCA). The CCA results were served as Fgolden standard" to evaluate the diagnostic seusibility, specificity and accuracy of dual-source CTCA in diagnosing coronary artery stenosis. Results All of 10 flying personnel accepted dual-source CTCA and CCA successfully. Satisfied image quality was obtained in 96.3% of all CTCA images. Fifteen segments were diagnosed stenosis in 7 flying personnel in CTCA images, while myocardial bridge in 2 and coronary artery fistula in 1. According to CCA results, the sensitivity, specificity and accuracy of CTCA in diagnosing coronary artery segment stenosis and stenosis (≥50%) were 100.0%, 98.2%, 98.4% and 80.0%, 99.2%, 98.4%, respectively. Conclusion As a noninvasive method which could evaluate coronary artery stenosis accurately, dual-source CTCA is a valuable method to diagnose CAD in flying personnel safely and reliably.