64层螺旋CT冠状动脉成像质量分析

目的评价64层螺旋cT冠状动脉成像（64SCTCA）在诊断冠状动脉疾病中的临床价值。方法收集683例临床可疑冠心病患者SCTCA的完整资料，并在有冠状动脉造影（CAG）作对照且CT血管造影（CTA）图像质量为1、2级的患者中，随机选取30例患者共450个冠状动脉节段作定量评价，并分析冠状动脉CTA诊断不同程度狭窄的敏感性、特异性、阳性预测值及阴性预测值。结果683例患者中556例（81．4％）图像质量为1级，112例（16．4％）为2级，15例（2．2％）为3级，造成图像质量较差的原因主要是搏动伪影及呼吸伪影。所有1级、2级分支，绝大部分的3级分支和部分4级分支可得到良好显示。64SCTCA诊断不同程度冠状动脉狭窄的敏感性及阳性预测值均〉80％，特异性及阴性预测值均〉90％，其中轻度狭窄组最低，敏感性、特异性、阳性预测值及阴性预测值分别为81．2％，96．5％，90．8％，92．4％。结论64SCTCA对于冠状动脉狭窄的评估具有较高的诊断价值．适用于冠心病的筛查，具有重要的临床意义。

Analysis of coronary artery imaging quality on 64-slice spiral CT

Objective To evaluate the clinical value of coronary artery imaging with 64-slice spiral CT in the diagnosis of coronary artery disease. Methods Totally 683 patients suspected of coronary artery diseases（CAD） were examined by 64-slice spiral CT. In whom also compared with conventional coronary angiography（CCA） and the quality of CTA image was level 1 or 2,we randomly selected 30 patients with a total of 450 coronary segments for quantitative evaluation, then analyzed the sensitivity, specificity, positive predict values and negative predict values in diagnosing the degree of stenosis with coronary artery CT angiography. Results In total 683 patients,556 （81.4%） patients＇ im- age quality were grade 1 ,112 （16.4%）were grade 2,15 （2.2%）were grade 3,the main reason resulting in poor image quality was pulsatory artifacts and respiratory artifacts.All of the primary branch and secondary branch,most of the third level branch,part of the forth level branch were shown well.The sensitivity and positive predict values were more than 80%,while the specificity and negative predict values were more than 90% for the detection of coronary artery stenosis with 64-slice spiral CT .The mild stenosis group had the lowest sensitivity,specificity,positive predict values and negative predict values,which were 81.2%,96.5%,90.8% and 92.4%. Conclusion 64-slice CT coronary angiogra- phy has excellent diagnostic value in detecting coronary artery stenosis, it applys to screening of coronary artery dis- eases and has an important clinical significance.