64层螺旋CT冠状动脉造影对冠状动脉狭窄的诊断价值

目的：评价64层螺旋CT冠状动脉造影（64-slice CTCA）诊断冠状动脉狭窄的临床应用价值。方法：对120例临床怀疑冠状动脉疾病及支架置入术、冠脉搭桥术后的患者进行64层螺旋CT冠状动脉成像。采用回顾性心电门控扫描，并采用曲面重建、多平面重组，容积再现及最大密度投影技术显示冠状动脉主干及分支，其中30例患者近期行传统冠状动脉造影（CCA）。结果：120例患者可评价冠脉节段1377个，可满足诊断的冠脉节段1341个，占97．39％。30例患者近期行CCA检查，MSCTCA诊断冠脉狭窄节段103个与CCA相符，占88．03％，显示轻、中、重度狭窄及血管闭塞与CCA符合率分别为77．8％、93．3％、91．6％、77．8％，得出64SCTCA诊断冠脉狭窄敏感性97．52％，特异性96．02％，阳性预测值95．16％，阴性预测值96．01％。结论：64层螺旋CT冠状动脉造影在诊断冠状动脉疾病方面有很高的诊断价值，可以成为筛查、排除冠状动脉病变及支架、搭桥术后随访的常规检查方法。

The diagnostic value of 64-slice CT angiography (64-SCTCA) in coronary artery stenosis

Objective：To evaluate the diagnostic value of 64-slice CT coronary angiography （64-SCTCA） in coronary artery stenosis.Methods： 120 cases suspected of coronary artery disease or stem implantation, bypass grafting underwent retrospective ECG-gated 64-slice CT coronary angiography. Curved-planar reformation（CPR）, multiplanar reformation （MPR）, volume rendering（VR） and maximum intensity projeetion（MIP） were used to demostrate the coronary arteries. 30 eases underwent beth CTCA and CCA. Results： Images of 1341 segments in 120 cases （1377 segments） can meet the need of diagnosis, accounting for 97.39%. 30 control patients underwent CCA, 103 segments were confirmed by CCA, accounting for 88.03%. The sensitivity, specificity, positive predictive value and negative predictive value of 64-slice CTCA were 97.52%, 96.02%, 95.16%, 96.01%, respectively. Condusion-64-slice CTCA has high clinical value in diagnosis of coronary artery disease. It can be used as the routine examination in screening coronary artery disease and the follow-up of stent implantation and bypass grafting.