摘要
目的探究256排CT冠状动脉造影在诊断心肌梗死患者冠脉血管病变程度及心功能的临床价值。方法回顾性分析2018年12月至2019年12月我院心血管内科收治的370例确诊为心肌梗死患者的临床资料,所有患者行冠状动脉造影(CAG)检查前均进行超声心动图及256排CT检查,以CAG诊断作为“金标准”,分析MSCT、超声心动图诊断不同程度冠脉狭窄程度的敏感性、特异性、阳性预测值、阴性预测值及准确度;比较256排CT、超声心动图所测舒张末期容积(EDV)、收缩末期容积(ESV),通过计算得出每搏输出量(SV)及射血分数(EF)等心功能指标之间的差异,并进行相关性分析。结果256排CT可供评价节段显著高于超声心动图(P<0.05);256排CT在轻度冠脉狭窄诊断特异性及准确性显著高于超声心动图(P<0.05),在中度及重度狭窄诊断准确性显著高于超声心动图(P<0.05);超声心动图与256排CT所测EDV、ESV、SV、EF等心功能指标之间差异无统计学意义(P>0.05)。相关分析示,两种方法所测心功能指标呈正相关(P<0.05)。结论256排CT对心肌梗死患者冠脉血管病变程度诊断价值高于超声心电图,在心功能评价上与超声心动图相当。
Objective To investigate the clinical value of 256-slice CT coronary angiography in diagnosis of the severity of coronary vascular lesions and cardiac function in patients with myocardial infarction.Methods The clinical data of 370 patients with myocardial infarction diagnosed in department of cadiovascular diseases in the hospital from December 2018 to December 2019 were retrospectively analyzed.All patients underwent echocardiography and 256-slice CT before coronary arteriography(CAG).With CAG diagnosis as the"golden standard",the sensitivities,specificities,positive predictive values,negative predictive values and accuracy rates of MSCT and echocardiography for diagnosis of different degrees of coronary stenosis were analyzed.The end-diastolic volume(EDV),endsystolic Volume(ESV),cardiac function indicators such as stroke volume(SV)and ejection fraction(EF)measured by 256-slice CT and echocardiography were compared.Results Segments which could be evaluated by 256-slice CT were significantly,more than those by echocardiography(P<0.05).The specificity and accuracy of 256-slice CT in diagnosis of mild coronary stenosis were significantly higher than those of echocardiography(P<0.05).The diagnostic accuracy for moderate and severe stenosis was significantly higher than that of echocardiography(P<0.05).There was no significant difference in ESD,ESV,SV,EF or other cardiac function indexes between echocardiography and 256-slice CT(P>0.05).Correlation analysis showed that the cardiac function indicators measured by the two methods were positively correlated(P<0.05).Conclusion The diagnostic value of 256-slice CT is greater than echocardiography in diagnosis of the severity of coronary vascular lesions while they are equivalent in the evaluation of cardiac function in patients with myocardial infarction.
作者
张瑜
王晓慧
王莹
ZHANG Yu;WANG Xiao-hui;WANG Ying(Department of Radiology,East Care Cerebrovascular Ward of the Affiliated Hospital of Yan'an University,Yan'an 716000,Shaanxi Province,China;Department of Ultrasound Diagnosis,East Care Cerebrovascular Ward of the Affiliated Hospital of Yan'an University,Yan'an 716000,Shaanxi Province,China)
出处
《中国CT和MRI杂志》
2022年第2期69-71,148,共4页
Chinese Journal of CT and MRI
关键词
计算机体层成像
心肌梗死
冠脉血管病变
心功能
Computed Tomography
Myocardial Infarction
Coronary Vascular Lesion
Cardiac Function
