摘要
目的评价64层螺旋 CT(64-MSCT)诊断冠状动脉粥样硬化狭窄的准确性。方法61例疑似冠心病患者在5～20 d 内行64层 MSCT 冠状动脉成像(CTA)和血管造影(CAG)检查,其中男52例、女9例,平均年龄58岁±11岁。冠状动脉成像质量按照4分标准对右冠状动脉、左主干、左前降支和左回旋支4支血管分别进行评价。CTA 与 CAG 冠状动脉病变狭窄程度以50%为界,对以上4支血管进行评价。对比分析 MSCT 诊断冠状动脉狭窄程度≥50%和<50%的敏感性、特异性、假阳性、假阴性等指标。根据斑块的成分将其分为钙化和非钙化斑块两组,对二者所导致的管腔狭窄分别进行分析比较。结果所有61例患者均获得优良的冠状动脉影像,冠状动脉成像质量评分为(3.57±0.18)分。CTA 与 CAG 对比,诊断冠状动脉狭窄程度灵敏度为95.45%、特异度为96.15%、假阳性率为3.85%、假阴性率4.55%、阳性预测值为93.33%、阴性预测值为97.40%。对于非钙化斑块所致的管腔显著性狭窄的诊断敏感度和特异度均为85.71%;对于钙化斑块所致的显著性狭窄的诊断敏感度和特异度分别为83.33%和31.57%。结论64-MSCT 可准确显示冠状动脉硬化所致狭窄性病变,可用于冠心病的无创性检查,对于钙化斑块所导致的管腔狭窄的判断特异度低。
Objective To evaluate the diagnostic accuracy of 64 multislice computed tomagraphy （MSCT） coronary angiography on the coronary atherosclerosis. Methods Sixty one （52 male,9 female, averaged 58±11 yrs ） patients underwent conventional coronary angiography and 64-MSCT angiography for suspected coronary artery disease within 5 to 20 days. Coronary artery image quality was scored from 1 to 4 （ image quality score, 1 ： poor; 2 ： good - ; 3 ： good ＋ , and 4 ： excellent） on RCA, LM, LAD and LCX, respectively. The coronary artery stenosis were divided into two groups by over than 50% and less than 50% and diagnostic accuracy was analyzed. The coronary plaques were divided as calcified and noncalcified plaque according to its density. The stenosis result from calcified and noncalcified plaque were analyzed. Results Mean score of image quality on RCA, LM, LAD and LCX was 3.57±0.18 with heart beats 50 - 104 bpm （mean 70±11 bpm ）. Compared with CAG, the sensitivity and specificity of 64-MSCT in evaluating stenosis are 94. 45% and 96. 15% , the false positive and false negative value are 3.85% and 4. 55%. The sensitivity and specificity were 85. 71% in evaluating stenosis result from noncalcified plaque and they were 83.33% and 31.57% result from calcified plaque. Conclusion 64-MSCT is an accurate and feasible method in evaluating coronary artery stenosis compared to conventional coronary angiography. However the specificity was poor in evaluating calcified plaque.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2007年第46期3243-3246,共4页
National Medical Journal of China
