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目的:探讨64层螺旋CT冠脉成像对隐匿性冠心病的诊断价值。方法:应用64MDCT对61例LCHD行CT冠状动脉钙化积分、CT血管造影成像,其中21例患者于两周内行冠脉造影(SCA)检查,对其MDCT表现与常规、动态心电图和SCA结果进行对照。结果:64MDCT冠脉成像对隐匿性冠心病诊断率明显高于常规心电图及动态心电图,其特异性为81.82%,阳性预测值为89.09%,阴性预测值为93.10%,敏感性为96.08%,P<0.01,Kappa检验分析MDCT冠脉成像与SCA符合率较高。结论:64MDCT是无创性、早期诊断隐匿性冠心病的影像学检查技术,可为隐匿性冠心病的早期诊断和干预提供可靠、翔实的冠脉病变诊断信息。
Objective: To explore the value of 64-slice spiral CT coronary angiography in the diagnosis of occult coronary heart disease. Methods: Sixty-six patients with LCHD underwent computed tomography coronary angiography and CT angiography. Sixty-one patients underwent coronary angiography (SCA) within two weeks, and their MDCT findings were compared with those of conventional, ambulatory electrocardiogram and SCA . Results: The diagnostic accuracy of 64MDCT coronary angiography was significantly higher than that of conventional ECG and ambulatory electrocardiogram. The specificity of 64MDCT coronary angiography was 81.82%, the positive predictive value was 89.09%, the negative predictive value was 93.10%, the sensitivity was 96.08%, P <0.01, Kappa test analysis of MDCT coronary angiography and SCA coincidence rate higher. Conclusion: 64MDCT is a noninvasive, early diagnostic imaging technique of occult coronary heart disease, which can provide reliable and informative diagnostic information of coronary lesions for the early diagnosis and intervention of occult coronary heart disease.