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目的探讨16层多层螺旋CT(MSCT)冠状动脉成像的临床应用价值。方法对80例(60例临床确诊或疑有冠心病,20例为45岁以上干部体检)行16层MSCT冠脉成像检查,其中10例作了导管法冠脉造影对照。对冠脉各节段显示数量以及有无病变等进行统计、分析,评价16层MSCT冠脉成像对≥50%血管狭窄的敏感性、特异性、阳性预测值与阴性预测值。结果80例共显示774个≥2mm的节段,有87个节段显示不同程度狭窄,185个节段有不同程度动脉粥样硬化斑块。在同时作了冠脉DSA对照的10例中,16层MSCT冠脉成像对≥50%狭窄的敏感性、特异性、阳性预测值和阴性预测值分别为84.6%、98.8%、91.7%和97.7%。结论16层MSCT冠脉成像简便、安全、易行,特别适于门诊患者以及特殊人群的普查;对于介入手术筛选和术后复查,可以部分取代导管法冠脉造影。
Objective To investigate the clinical value of 16-slice multi-slice spiral CT (MSCT) coronary angiography. Methods 16 cases of MSCT coronary angiography were examined in 80 cases (60 clinically diagnosed or suspected coronary heart disease and 20 cases of cadres aged 45 years or older), of whom 10 were catheterized coronary angiography. The number of coronary segments showed as well as the presence or absence of lesions were statistically analyzed and evaluated for the sensitivity, specificity, positive predictive value and negative predictive value of 16-slice MSCT coronary angiography for ≥50% vascular stenosis. Results 80 cases showed a total of 774 ≥ 2mm segments, 87 segments showed varying degrees of stenosis, 185 segments with varying degrees of atherosclerotic plaque. The sensitivity, specificity, positive predictive value, and negative predictive value of 16-slice MSCT coronary angiography were 84.6%, 98.8%, 91.7% and 97.7%, respectively, of the 10 patients who underwent coronary DSA at the same time %. Conclusion The 16-slice MSCT coronary angiography is simple, safe and easy to perform. It is especially suitable for the screening of outpatients and special populations. It can partially replace catheterization coronary angiography for interventional surgery screening and postoperative review.