多层螺旋CT血管成像对冠状动脉狭窄的临床应用

目的：探讨多层螺旋CT血管成像（multi-slice spiral CT angiography，MSCTA）对冠状动脉狭窄的临床应用价值。方法：对临床可疑冠状动脉狭窄的23例患者进行了多层螺旋CT（multi-slice spiral CT，MSCT）及选择性冠状动脉造影（selective coronary angiography，SCA）检查，男14例，女9例，年龄35-76岁。以管腔狭窄≥50％为诊断标准，将MSCTA与SCA检查结果进行对照分析，评价MSCTA在诊断冠状动脉狭窄中的应用价值。结果：23例患者中，用于评价的92个血管分支中2种检查方法均为阳性的血管节段为30支，均为阴性者8支，SCA阳性而MSCrA阴性1支，SCA阴性而MSCTA阳性5支，MSCTA敏感度96．8％，特异度61．5％，阳性预测值85．7％，阴性预测值88．9％；MSCrA诊断冠状动脉狭窄和SCA有很好的一致性（P〉0．005）；21例冠状动脉狭窄阳性患者中有17例发现冠状动脉壁存在钙化。结论：MSCTA对冠状动脉狭窄具有重要的临床应用价值。

Clinical application of multi-slice spiral CT angiography in coronary artery stenoses

Objective：To explore the applicational value of multi-slice spiral CT angiography （MSCTA） in the diagnosis of coronary artery stenoses. Methods： 23 patients （ 14 males, 9 females, aged from 35 to 76 years old） clinically suspicious of coronary artery stenoses underwent multi-slice spiral CT and selective coronary angiography （SCA） studies. Applicational values of MSCTA in coronary artery stenoses were evaluated depending on the comparative findings between MSCTA and SCA, diagnostic referrence as luminal stenosis≥ 50%. Results： Among 92 coronary branches of 23 patients evaluated, 30 branches with stenoses were detected with MSCrA and SCA, 8 branches with non-steneses with these two modalities, 1 branch with positive SCA and negative MSCTA, 5 branches with negative SCA and positive MSCTA. Sensitivity, specificity,the positive and negative predictive value of MSCTA were 96.8%, 61.5%, 85.7% and 88.9% respectively. Detective findings of MSCTA and SCA in coronary stenoses matched well. Conclusion： MSCTA, as a noninvasive modality, is a valuable method in detecting coronary artery stenoses.