摘要
目的探讨256层螺旋CT在冠状动脉成像及管腔狭窄诊断中的应用价值。方法选取200例临床疑诊或拟诊为冠心病的患者,均行256层螺旋CT扫描,其中32例行冠状动脉血管造影（CAG）。按照美国心脏协会（AHA）制订的冠状动脉分段方法,将冠状动脉细分为15个节段,分别对各节段CTA图像质量进行评价,并以CAG为金标准,评价CTA对冠状动脉不同狭窄程度的诊断能力。结果 CTA显示冠状动脉节段共2 502段,其中,评分为4分~5分者共2 385段（可评价率为95.32%）。以CAG为金标准,256层螺旋CTA诊断冠状动脉狭窄的灵敏度为90.52%,特异度为91.54%,准确率为91.24%,两种方法评价冠状动脉狭窄的一致性较高,Kappa值为0.797;而分级诊断冠状动脉轻、中、重度狭窄的灵敏度分别为66.67%、83.87%、89.19%。结论 256层螺旋CTA可以较清晰的显示冠状动脉各节段图像,且较好的评估病变管腔狭窄程度。由此可见,256层螺旋CTA作为一种无创检查方法,在冠心病的筛查中具有重要的临床应用价值,为冠心病患者进一步治疗方案的选择提供更加可靠的信息。
Objective To investigate the application value of 256- slice CT angiography（CTA） for diagnosing coronary artery steno- sis. Methods Two hundred patients suspected of coronary heart disease underwent 256-slice CTA examination,32 of whom under- went coronary angiography. According to the American Heart Association （AHAI） for coronary artery segment method, coronary artery could be divided into 15 segments,to evaluate the image quality of each segment on a five -point scale. The CAG results were regar- ded as gold standard,the diagnosis capacity of CTA for detecting coronary artery stenosis were analyzed. Resutls 2 385 segments were considered four and five score of 2 502 segments shown with CTA examination. Compared with the CAG results,the accuracy rate of 256 - slice CTA in diagnosing coronary artery stenosis was 91.24% ,the sensitivity was 90. 52% ,and the specificity was 91.54%, there was high consistency in the results of CTA and CAG in diagnosing coronary artery stenosis. The sensitivity rates of CTA for e- valuating the different coronary artery stenosis were：mild stenosis （66. 67%）, moderate stenosis （B3. 87% ）, severe stenosis （B9. 19% ）. Conclusion The 256 - slice CTA can display each segment of coronary artery clearly, and analysis and evaluate the segmen tal stenosis better. So,as a noninvasive examination, the 256- slice CTA has important clinical value Jn the screening of coronary heart disease（CHD） ,and it can provide more reliable information for the selection of treatment.
出处
《中西医结合心脑血管病杂志》
2015年第17期1972-1975,共4页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
山西省科技攻关计划项目(No.20130313016-2)
