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目的:评价多层螺旋CT冠状动脉造影(MSCTA)在冠状动脉病变中的诊断意义。方法:108例老年患者行MSCTA,记录冠状动脉钙化的部位及钙化积分、冠状动脉狭窄的部位及支数,同期进行动态和静息单光子发射计算机断层核素心肌灌注显像(SPECT)及选择性冠状动脉血管造影术,以冠状动脉血管造影检查为金标准,将检查结果逐一对照,并进行统计学分析。结果:MSCTA检查诊断冠心病的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为77%,72%,88%,54%,76%;诊断单支、2支、和3支冠状动脉病变的敏感性分别为63%、91%、96%;与SPECT检查联合评价,诊断冠心病的敏感性、特异性、阳性预测值、阴性预测值可提高到99%、93%、96%、94%;冠状动脉钙化积分随危险因素及冠状动脉病变累及的支数增多而增加,对≥65岁男性患者,冠状动脉钙化积分≥200意义较大。结论:MSCTA可一次性完成冠状动脉钙化积分和狭窄评价,对评价冠状动脉狭窄有一定的价值,尤其结合SPECT可明显提高诊断的正确性,可作为冠状动脉血管造影术术前筛选的常规无创性检查方法。
Objective: To evaluate the diagnostic value of multislice CT coronary angiography (MSCTA) in the diagnosis of coronary artery disease. Methods: A total of 108 elderly patients underwent MSCTA. The location of coronary artery calcification, calcification score, location and number of coronary artery stenosis were recorded. Dynamic and resting single photon emission computed tomography myocardial perfusion imaging (SPECT) and selection Coronary angiography, coronary angiography as the gold standard, the test results one by one control, and statistical analysis. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MSCTA in diagnosis of coronary heart disease were 77%, 72%, 88%, 54% and 76% respectively. One, two and three The sensitivity, specificity, positive predictive value and negative predictive value of coronary artery disease with coronary artery disease were 63%, 91%, 96%, respectively. The predictive value of SPECT combined with SPECT could be improved to 99%, 93% 96%, 94%. The score of coronary artery calcification increased with the increase of the number of risk factors and the number of coronary lesions. For coronary heart disease≥65 years old, the score of coronary artery calcification≥200 was significant. Conclusion: MSCTA can be used to evaluate coronary artery calcification score and stenosis in one time. It is of value in assessing coronary artery stenosis. In particular, MSCTA can significantly improve the diagnostic accuracy and can be used as a routine noninvasive preoperative coronary angiography Inspection Method.