大螺距双源CT冠脉成像和冠状动脉造影的对比研究

目的探讨第二代双源CT对冠状动脉狭窄的准确性的诊断价值。方法 60例临床可疑或已知冠心病患者行双源CT冠状动脉成像(CTCA)检查,入选采用Flash spiral模式扫描并于10天内行冠状动脉造影(CAG)检查,以CAG结果作为金标准,评价双源CT对冠状动脉狭窄程度的的敏感度、特异度、阳性预测值及阴性预测值,评价第二代双源CT对冠状动脉狭窄的诊断价值。结果 60例患者显示冠状动脉240支共740节段,以冠状动脉造影为参考标准,基于节段水平分析,CTCA诊断冠状动脉狭窄的敏感性、特异性、阳性预测值、阴性预测值及准确率分别为84.4%、97.0%、86.4%、96.50%、94.7%;基于血管分析,CTCA诊断冠状动脉狭窄的敏感性、特异性、阳性预测值、阴性预测值及准确率分别为85.5%、92.3%、90.4%、88.2%、89.2%。结论大螺距双源CT Flash spiral模式作为一项新的成像方法,检出冠状动脉狭窄的准确率较高,作为冠心病的一种无创筛查手段有较高的临床应用价值。

High-pitch spiral acquisition daul-source CT in coronary artery disease:comparison with coronary angiography

Objective To evaluate the diagnostic accuracy using Flash dual-source CT for the diagnosis of significant coronary stenosis.Methods Sixty patients underwent dual-source CT and conventional coronary angiography(CAG).The CAG results were served as the "gold standard" to evaluted the diagnostic accuracy of CTCA in coronary artery significant stenosis.Results There were 740 vessel segments of 240 coronary artery bunches in sixty patients.CAG served as the standard of reference.The sensitivity,specificity,positive predictive value,negative predictive value and agreement rate of DSCT were 84.4%,97.0%,86.4%,96.5% and 94.7% in per-segment analysis respectively.In per-artery analysis,the sensitivity,specificity,positive predictive value,negative predictive value and agreement rate of DSCT were 85.5%,92.3%,90.4%,88.2% and 89.2% respectively.Conclusions CTCA using high-pitch spiral mode of the Flash dual-source CT is a new method for diagnosing the coronary artery stenosis which provided a high diagnostic accuracy and has a high clinical value.