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16层螺旋CT冠状动脉成像初步探讨 被引量:24

Initial experiences about 16-detector row CT coronary angiography
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摘要 目的探讨心率与多层螺旋 CT(MSCT)冠状动脉(简称冠脉)成像运动伪影的关系,及MSCT 冠脉成像的临床应用价值。方法对200例临床拟诊冠心病的患者行 MSCT 冠脉成像检查,分析扫描时心率与冠脉运动伪影的关系;其中37例同时行常规冠脉造影(简称冠造)检查,对比分析2种检查结果。结果扫描时心率≤55次/min、56~60次/min、61~65次/min、66~70次/min和>70次/min 组有运动伪影的冠脉节段分别占冠脉总数的0.1%(1/759)、1.1%(7/649)、2.5%(10/407)、42.6%(103/242)和75.5%(108/143);以常规冠造作为金标准,MSCT 诊断狭窄≥50%的敏感度、特异度、阳性预测值、阴性预测值分别为79.2%、96.0%、83.8%、94.6%。扫描时心率与冠脉运动伪影的数量显著相关(r=0.655,P=0.000)。结论 MSCT 能较准确诊断冠脉50%以上的狭窄,是无创性诊断冠脉狭窄的重要工具。 Objective To investigate the influence of a patient's heart rate on the presence of motion artifacts and on accuracy of stenosis detection on contrast-enhanced MSCT. Methods Two hundred patients with suspected coronary artery disease underwent the contrast-enhance MSCT, the main factors influencing imaging quality were analyzed. Thirty-seven patients underwent conventional selective coronary angiography in the same time. The results obtained from MSCT were compared. Results In the 5 groups (heart rate≤55 bpm, 56--60 bpm, 61--65 bpm, 66--70 bpm, 〉70 bpm during scan) , the proportion of segments that could not be assessed because of motion artifact were 0. 1% (1/759) , 1, 1% (7/649), 2, 5% ( 10/407 ) , 42. 6% ( 103/242 ), and 75.5% ( 108/143 ) , respectively. With conventional selective coronary angiography as the golden standard, the sensitivity, specificity, positive and negative prediction values to detect 〉150% stenotic lesions in the assessable segments were 79. 2% , 96. 0% , 83.8% , and 94. 6% , respectively. There was a significant correlation between the number of segments per patient not assessable because of motion artifact and heart rate during the scan ( r = 0. 655, P = 0. 000 ). Conclusion MSCT is capable of achieving high accuracy for detection of coronary artery stenosis, and is a reliable technique to diagnose coronary artery disease.
出处 《中华放射学杂志》 CAS CSCD 北大核心 2006年第10期1064-1068,共5页 Chinese Journal of Radiology
关键词 冠状动脉疾病 体层摄影术 X线计算机 心血管造影术 Coronary disease Tomography,X-ray computed Angiocardiography
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参考文献5

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