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目的评价双源CT(DSCT)冠状动脉成像对冠状动脉狭窄诊断的准确性。方法分析2007年7月—11月间32例临床怀疑或确诊冠心病的患者(男23例,女9例,平均年龄56.2岁)DSCT冠状动脉成像检查和冠状动脉造影(CAG)的资料,以冠状动脉造影结果为金标准探讨DSCT冠状动脉成像检出冠状动脉狭窄病变的准确性。结果32例中,DSCT显示的冠状动脉直径≥1.5mm的节段有436个,431个冠脉节段可以进行评估,可评估率为98.85%。DSCT发现冠状动脉狭窄的敏感性:99.17%(119/120),特异性:97.43%(303/311),阳性预测值:93.70%(119/127),阴性预测值:99.67%(303/304)。对于冠状动脉狭窄检出的准确率为95.00%。配对χ2检验结果说明DSCT和CAG两种检查方法在诊断冠状动脉狭窄病变上差异没有统计学意义(P=0.077)。同时,Kappa一致性检验说明DSCT和CAG两种检查方法在诊断冠状动脉狭窄分级方面存在一致性(κ=0.930)。结论DSCT对检出冠状动脉狭窄准确性高,可作为高危人群冠心病筛查的首选方法。
Objective To evaluate the accuracy of double-source CT (DSCT) coronary angiography in the diagnosis of coronary artery stenosis. Methods The data of DSCT coronary angiography (CAG) and coronary angiography (CAG) were analyzed in 32 patients with suspected or confirmed coronary heart disease (23 males and 9 females, mean age 56.2 years) from July 2007 to November 2007 Coronary angiography results for the gold standard DSCT coronary angiography to detect coronary artery stenosis accuracy. Results Among 32 cases, DSCT showed 436 segments with coronary artery diameter≥1.5mm and 431 coronary segments could be evaluated with an assessable rate of 98.85%. The sensitivity of DSCT in detecting coronary artery stenosis was 99.17% (119/120), specificity was 97.43% (303/311), positive predictive value was 93.70% (119/127), negative predictive value was 99.67% (303/304 ). The accuracy of detection of coronary artery stenosis was 95.00%. Paired χ2 test results show that DSCT and CAG two methods in the diagnosis of coronary artery stenosis was no significant difference (P = 0.077). At the same time, Kappa consistency test showed that the two methods of DSCT and CAG were consistent in the diagnosis of coronary artery stenosis (κ = 0.930). Conclusions DSCT has high accuracy in detecting coronary artery stenosis and can be used as the first choice of coronary heart disease screening in high-risk population.