目的评价冠状动脉CT血管成像(CCTA)对冠心病等危症患者诊断心肌缺血的价值。方法回顾性收集100例均接受了CCTA与负荷核素心肌灌注显像(MPI)的冠心病等危症患者。采用目测直径法对CCTA图像狭窄程度进行判定,冠状动脉狭窄分为<50%,50%~69%和≥70%。相应MPI图像上心肌节段的核素分布分为:灌注正常及灌注异常。结果 400条冠状动脉中,22条冠状动脉狭窄程度≥50%,其中10条(45%)相应的心肌供血区域在MPI图像上出现心肌灌注异常;378条冠脉血管狭窄程度<50%及正常,其中18条(4.8%)冠状动脉的心肌供血区域在MPI图像上出现心肌灌注异常。CCTA对评估心肌缺血诊断的灵敏度、特异度、阳性预测值和阴性预测值分别为36%、97%、45%和95%。结论 CCTA用于诊断冠心病等危症患者心肌缺血时,确定诊断性能较低,排除诊断性能较好。 Objective To evaluate the value of coronary artery CT angiography (CCTA) in the diagnosis of myocardial ischemia in patients with coronary heart disease and other crisis. Methods Retrospectively collected 100 cases of patients with coronary heart disease and other critically ill patients who underwent CCTA and load nuclide myocardial perfusion imaging (MPI). The degree of stenosis of CCTA was determined by visual diameter method. Coronary stenosis was classified as <50%, 50% -69% and> 70%. The corresponding MPI images on the myocardial segment of the radionuclide distribution is divided into: normal perfusion and perfusion abnormalities. Results Among the 400 coronary arteries, the degree of stenosis of 22 coronary arteries was ≥50%. The myocardial perfusion abnormalities in MPI images were found in 10 (45%) of the corresponding myocardial areas. 378 coronary stenosis was less than 50% and normal , Of which 18 (4.8%) coronary artery myocardial perfusion area in the MPI images of myocardial perfusion. The sensitivity, specificity, positive predictive value and negative predictive value of CCTA for the assessment of myocardial ischemia were 36%, 97%, 45% and 95%, respectively. Conclusions CCTA was used to diagnose myocardial ischemia in CHD patients with lower diagnostic performance and better diagnostic performance.