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目的探讨多层螺旋CT对于冠状动脉疾病的筛选价值。方法对70例(包括61例拟诊冠心病患者,9例PTCA术后患者)行16层螺旋CT冠状动脉血管造影(16SCTCA)检查,对16SCTCA显示的冠状动脉情况进行评估,其中18例冠状动脉有病变者进行冠状动脉造影(CAG)对比分析,评估16SCTCA对于冠状动脉疾病的检出情况。结果每例对冠状动脉的18段血管进行分析,70例患者共显示可用于诊断的图像1083段,占应显示血管86.0%;其中显示钙化27例70段血管,检出冠状动脉发育异常17例,其中检出心肌桥-壁冠状动脉(MB-MCA)7例,检出冠状动脉有临床意义狭窄18例30段。16SCTCA诊断≥50%狭窄敏感度为93.8%,特异度为98.3%,阳性预测值为86.7%,阴性预测值为99.3%。结论16SCTCA对于冠状动脉疾病具有较高的敏感性和特异性,评价病变程度较可靠,可发现冠状动脉发育异常,是适合于筛选冠状动脉疾病的无创性检查方法。
Objective To investigate the screening value of multislice spiral CT in coronary artery disease. Methods 16 cases of spiral CT coronary angiography (16SCTCA) were examined in 70 patients (including 61 patients diagnosed with coronary heart disease and 9 patients after PTCA), and the coronary arteries showed by 16SCTCA were evaluated. Among them, 18 cases of coronary arteries Patients with lesions were compared coronary angiography (CAG) to assess the detection of 16SCTCA coronary artery disease. Results In each case, 18 segments of coronary arteries were analyzed. Seventy-three patients showed 1083 segments, accounting for 86.0% of the total. Seventeen segments of 70 vessels were calcified and 17 cases of coronary artery abnormalities were detected Among them, 7 cases of myocardial bridge-wall coronary artery (MB-MCA) were detected and 18 cases of coronary artery stenosis were detected in 30 cases. The sensitivity and specificity of ≥50% stenosis were 93.8%, 98.3%, 86.7% and 99.3% respectively. Conclusion 16SCTCA has high sensitivity and specificity for coronary artery disease. It is more reliable to evaluate the degree of lesion and can detect abnormalities of coronary artery. It is a noninvasive method suitable for screening coronary artery disease.