摘要
目的: 评价16层螺旋CT冠状动脉成像在冠状动脉狭窄中的临床应用价值,以及不同性质的斑块对管腔狭窄评价的影响。方法:38例患者同时行16层螺旋CT冠状动脉成像和传统冠状动脉造影DSA(CAG)检查,以CAG为“金标准”,将二者进行对照。结果:16层螺旋CT判断冠状动脉轻度、中度及高度狭窄的灵敏度、特异度、阳性预测值、阴性预测值分别为72.7%、38.5%、50%、62.5%;82.4%、72.7%、70%、84.2%;85%、90.5%、81%、92.7%。随着冠脉狭窄程度的增加,16层CT对其诊断价值增高。严重钙化、中度钙化及未钙化斑块对冠脉中度及中度以上狭窄评价的灵敏度、特异度、阳性预测值、阴性预测值分别为 73. 3%、22. 2%、61. 1%、33. 3%; 70%、55. 6%、63. 6%、62. 5%; 93. 8%、85. 7%、93.8%、85.7%。16层螺旋CT对管壁钙化的冠脉狭窄程度的评价仍有局限性,钙化程度越重,对管腔狭窄的评价困难越大,而对未钙化斑块的评价有较高价值。结论:16 层螺旋 CT冠状动脉成像是一种简便易行、安全可靠的无创性检查方法,可作为冠心病的筛选手段和冠脉术前评价和术后复查的首选方法。
Objective:To evaluate the clinical application value of 16-slice MSCT coronary angiography and the impact of different kinds of plaques on evaluation of the stenosis of coronary artery.Methods:38 patients underwent both 16-slice MSCT and conventional coronary angiography,and the results of the both methods were compared.Results:The sensitivity,specificity,positive and negative predictive value to identify mild,medium and significant stenosis of coronary artery with 16 slice MSCT were 72.7%,38.5%,50%,62.5%;82.4%,72.7%,70%,84.2% and 85%,90.5%,81%,92.7% respectively.With the increase of stenosis,the accuracy of MSCT was increased.The sensitivity,specificity,positive and negative predictive value to identify ≥50% stenosis caused by significant calcification,medium calcification and non-calcified plaque were 73.3%,22.2%,61.1%,33.3%;70%,55.6%,63.6%,62.5% and 93.8%,85.7%,93.8%,85.7% respectively.MSCT had limitation in the evaluation of coronary artery stenosis caused by calcification,but MSCT has significant value in the evaluation of non-calcified plaque.Conclusion:16-slice MSCT coronary angiography is a simple,reliable and noninvasive method.MSCT can display the anatomical structure of coronary artery and also can identify the stenosis,especially the significant stenosis (≥50%) and non-calcified plaque.It had great value in the screening for suspected coronary artery disease and for pre- and post-operative examination.
出处
《放射学实践》
2005年第3期195-198,共4页
Radiologic Practice
