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目的探讨64排螺旋CT检查老年冠心病并糖尿病患者冠脉病变程度及冠脉内病变性质的应用价值。方法对52例临床诊断为冠心病并糖尿病的老年患者行冠状动脉64排螺旋CT冠脉造影(CTA)及常规选择性冠状动脉造影(CAG)检查。对CTA增强扫描轴位图像行多平面重建、容积再现、最大密度投影、曲面重建、仿真血管内镜等后处理,评估冠脉管腔狭窄程度及斑块性质。成像、造影以CAG为金标准,分析CTA的诊断价值。结果 CAG发现狭窄段174个,CTA正确检出155个(89.1%)。其诊断冠状动脉狭窄的敏感性为89.1%,特异性为92.8%,准确率91.9%,阳性预测值81.2%,阴性预测值96.1%。结论 CTA对冠状动脉狭窄有较高的诊断价值。
Objective To investigate the value of 64-slice spiral CT in detecting coronary artery disease and coronary artery disease in elderly patients with coronary heart disease and diabetes mellitus. Methods Coronary artery 64-slice CT angiography (CTA) and routine selective coronary angiography (CAG) were performed in 52 elderly patients with clinically diagnosed coronary heart disease and diabetes mellitus. Multi-plane reconstruction, volume rendering, maximum density projection, surface reconstruction and simulation of endoscopic treatment of CTA-enhanced axial images were performed to evaluate the extent of coronary stenosis and plaque quality. Imaging, angiography with CAG as the gold standard, the diagnostic value of CTA. Results CAG found that there were 174 stenosis segments and 155 (89.1%) correctly detected by CTA. The diagnosis of coronary artery stenosis was 89.1%, specificity was 92.8%, the accuracy rate of 91.9%, the positive predictive value of 81.2%, the negative predictive value of 96.1%. Conclusion CTA has high diagnostic value of coronary artery stenosis.