Flash双源CT冠脉成像与心肌灌注显像对冠心病诊断价值的临床研究

目的探讨Flash双源CT冠状动脉成像（DS—CTA）与心肌灌注显像（DS—CTP）一站式检查对冠心病诊断的价值。方法对60例临床考虑冠心病的患者行双源CT检查，所有患者均接受冠状动脉造影检查。以冠状动脉造影为参考标准，根据冠脉造影结果分为狭窄〈50％和狭窄≥50％，计算对于狭窄≥50％者双源CT冠脉成像及联合心肌灌注显像对冠心病诊断的敏感性、特异性、阳性预测值、阴性预测值和准确性。结果60例患者行DSCT冠脉成像与心肌灌注显像，其中59例均显示良好符合诊断要求。以冠状动脉造影为参考标准：①对于血管狭窄≥50％的血管，Flash双源CT诊断敏感性、特异性、阳性预测值和阴性预测值分别为84．O％、92．7％、88．9％和89．1％；②DS—CTA联合DS—CTP诊断冠心病的敏感性、特异性、阳性预测值和阴性预测值分别为96．8％、90．7％％、88．5％和97．5％。结论DS—CTA联合DS—CTP对冠心病具有很高的诊断价值。双源CT这种融合解剖学及功能学成像的“一站式”检查方法在冠心病的诊断及预后方面有重要优势。

The clinical experience of Dual-source CT angiography plus CT perfusion in coronary artery diease

Objective To evaluate the feasibility of diagnosing coronary stenosis and myocardial ischemia with a single dual-energy CT（DSCT） acquisition. Methods Sixty patients underwent dual-source dual energy CT and conventional coronary angiography（CAG）. The CAG results were served as ＂gold standard＂ to evaluate the diagnostic accuracy of DSCT in coronary artery significant stenosis （diameter reduction ≥ 50%）. To compared the following results： DS-CTA vs CAG to assess the sensitivity and specificity for detection of≥50% stenosis, and further assess the sensitivity and specificity DS-CTA plus DS-CTP with CAG. Results DSCT obtained diagnostic image quality in 59 patients. Using CAG as a reference, the sensitivity of DS-CTA was 84.0%, specificity was 92.7%, positive predictive value was 88.9%, negative predictive value was 89.1%. The combination of DS-CTA and DS-CTP sensitivity was of 96.8%, specificity of 90.7%, positive predictive value of 88.5%, negative predictive value of 97.5%. Conclusion DSCT as a possibly feasible single imaging investigation for the comprehensive diagnosis of coronary stenosis and myocardial ischemia .provide a high diagnosis and prognosis of CAD.