16排CT在评价胸痛患者冠状动脉病变中的应用价值

目的：探讨16排计算机断层扫描技术(CT)在评价胸痛疑似冠心病患者冠状动脉病变中的应用价值。方法：52例胸痛疑似冠心病患者人选,分别用16排CT造影方法(CTA)和常规冠状动脉造影方法(CAG)评价冠状动脉病变情况,并以CAG为标准计算CTA诊断冠状动脉病变的敏感度、特异度、阳性预测值(PPV)和阴性预测值(NPV)。结果：CTA能评价所有627个冠状动脉节段中的546个(87%)。在该546个冠状动脉节段中,CTA诊断冠状动脉病变的敏感度、特异度、PPV和NPV分别是94%、95%、82%和99%；CTA对冠状动脉左主干及其近中段病变的敏感度、特异度、PPV和NPV均高于冠状动脉远段和分支血管。结论：CTA能较准确地评价胸痛疑似冠心病患者冠状动脉(尤其是近、中段)的病变情况。

Clinical value of sixteen-detector row computed tomography angiography for the evaluation of coronary artery disease in patients with chest pain

Objective To evaluate the clinical value of sixteen-detector row computed tomography angiography (CTA) for the evaluation of coronary artery disease in the patients with chest pain suspected of coronary heart disease. Methods Fifty-two patients with chest pain suspected of coronary heart disease were,examined by CTA with sixteen- detector row CT and by conventional invasive coronary angiography (CAG) respectively for the evaluation of coronary artery disease.The sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of CTA were evaluated by the results of CAG.Results Among all the 627 coronary artery segments,546 (87%) were evaluated by CTA.Of the 546 assessable coronary artery segments,the sensitivity,specificity,PPV and NPV of CTA were 94%,95%, 82% and 99%,respectively.The sensitivity,specificity,PPV and NPV of CTA in the diagnosis of left main disease and proximal,middle segment of coronary artery disease were higher than those of CTA in the diagnosis of distal segment of coronary artery disease and side branches disease.Conclusions CTA technology can accurately evaluate the coronary artery disease (especially for proximal and middle segment) in the patients with chest pain suspected of coronary heart disease.