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目的探讨双源CT(dual source computed tomography,DSCT)冠状动脉扫描对评价60岁以上老年患者冠状动脉病变的临床应用的有效性和准确性。方法选择在2009年7月至2010年6月间于我院就诊的107例60岁以上疑有冠状动脉狭窄的老年患者,对其中102例进行DSCT和选择性冠状动脉造影(selective coronary angiography,SCA)检查。以SCA的结果为金标准,将DSCT的结果与SCA的结果进行比较,评价DSCT对诊断60岁以上老年患者冠状动脉狭窄病变,评价冠状动脉狭窄部位及狭窄程度的敏感性、特异性、阳性预测值、阴性预测值和准确性。结果 102例患者中SCA与DSCT检查出存在中度或中度以上冠状动脉狭窄(狭窄≥50%)的分别为52例和56例。DSCT正确地鉴别出中度或中度以上冠状动脉狭窄患者的敏感性98.1%,特异性90.0%,阳性预测值91.1%,阴性预测值97.8%,准确率94.1%。本研究评估了408支冠状动脉的影像,SCA与DSCT检查发现中度或中度以上冠状动脉狭窄分支的分别为96支和104支。DSCT诊断中度或中度以上冠状动脉狭窄的敏感性95.8%,特异性96.2%,阳性预测值88.5%,阴性预测值98.7%,准确率96.1%。结论 DSCT在老年患者中是一种有效的、能够准确地发现冠状动脉狭窄的检查方法。
Objective To investigate the efficacy and accuracy of dual source computed tomography (DSCT) coronary angiography in the evaluation of coronary artery disease in elderly patients over 60 years of age. Methods A total of 107 elderly patients over 60 years of age with suspected coronary artery stenosis who were treated in our hospital from July 2009 to June 2010 were enrolled in this study. Among them, 102 patients underwent DSCT and selective coronary angiography (SCA) )an examination. The SCA results as the gold standard, the results of the DSCT and SCA results were compared to evaluate the DSCT in the diagnosis of coronary heart disease in patients over the age of 60 stenosis, evaluation of coronary stenosis and stenosis degree of sensitivity, specificity, positive predictive Value, negative predictive value and accuracy. Results In 102 patients, there were 52 cases and 56 cases of coronary artery stenosis (≥50% stenosis) detected by SCA and DSCT respectively. DSCT correctly identified 98.1%, 90.0%, 91.1% of positive predictive value, 97.8% negative predictive value, and 94.1% of accuracy in patients with moderate or severe coronary artery stenosis. In this study, images of 408 coronary arteries were evaluated. SCA and DSCT revealed 96 and 104 coronary artery stenosis branches, respectively. The sensitivity, specificity, and specificity of DSCT in diagnosis of coronary artery stenosis were 95.8%, 96.2%, 88.5%, 98.7%, 96.1% respectively. Conclusion DSCT is an effective and accurate method for detecting coronary artery stenosis in elderly patients.