256层CTA技术在冠状动脉硬化狭窄诊断中的应用价值

目的 探讨256层CT血管成像（CTA）技术在冠状动脉成像及其狭窄诊断中的应用价值.方法 选择临床拟诊或疑诊冠状动脉疾病者400例,均行CTA冠状动脉检查,其中53例行DSA冠状动脉造影;由2名医生对图像质量评价,采用分级评分法评价冠状动脉15节段.结果 CTA显示冠状动脉节段共5 793个,其中评分为4、5分5 691个（98.24％）;与DSA比较,CTA诊断冠状动脉狭窄的准确率为94.33％、特异性为93.75％、敏感性为94.59％.DSA与CTA两种检查方法诊断冠状动脉狭窄一致性较好,Kappa为0.868.256层CTA诊断冠状动脉狭窄,在不同心率患者间差异无统计学意义.结论 256层CTA冠状动脉成像质量较高,可清晰地显示冠状动脉主要节段影像,较为准确地诊断冠状动脉狭窄,特异性、敏感性较好,且不受心率影响.

Application value of 256-slice CT angiography in the diagnosis of coronary artery stenosis

Objective To investigate the value of 256-slice CT angiography （CTA） for detecting coronary artery ste- nosis. Methods Four hundred patients suspected of coronary heart disease underwent 256-slice CTA examination. Of 53 cases, CTA results were retrospectively analyzed and compared with those of coronary artery DSA. Two observers independ- ently assessed image quality for all fifteen coronary segments on a five-point or dinal scale. Results 5 691 （98.24%） segments were considered four and five score of 5793 segments shown with CTA examination. Compared with the DAC ex- amination, the accuracy rat of CTA in diagnosing coronary artery stenosis was 94.33%, the specificity and sensitivity were separately 93.75% and 94.59%. There was good consistency in the results of CTA and DSA in diagnosing coronary artery stenosis, the value of Kappa was 0. 868. There were no statistical differences in diagnosing coronary artery stenosis with CTA among patients with different heart rates （P 〉 0.05）. Conclusion The 256-slice CTA coronary artery image has high image quality, which can clearly display the main section image of coronary artery and diagnose the coronary artery stenosis with high specificity and sensitivity.