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目的:评价冠状动脉CT造影(CCTA)诊断不同类型的冠状动脉粥样斑块所致冠状动脉狭窄的价值与限度。方法:连续80例完成CCTA及侵入性冠状动脉造影(ICA)检查的疑诊冠状动脉狭窄患者(男性62例,女性18例,年龄30~77岁,平均58岁)纳入研究,冠状动脉粥样斑块类型分为钙化性、非钙化性和混合性。以冠状动脉节段为单位,以ICA结果为金标准,运用相关分析及;Bland-Altman分析评价2种检查技术诊断三种斑块所致冠状动脉狭窄的一致性。结果:最终诊断明显冠脉狭窄(狭窄程度≥50%)49例108个节段;两种技术诊断钙化斑块性冠状动脉明显狭窄一致性差(r=0.720,P<0.01),非钙化和混合斑块性明显狭窄一致性良好(r=0.895,r=0.900,P<0.01)。结论:CCTA诊断非钙化性和混合性斑块所致冠状动脉狭窄准确性较好,钙化斑块性狭窄的诊断需慎重。
Objective: To evaluate the value and limitation of coronary artery CT angiography (CCTA) in diagnosing coronary artery stenosis caused by different types of coronary atherosclerotic plaques. Methods: A total of 80 consecutive patients with suspected coronary artery stenosis (62 males and 18 females, aged 30-77 years, mean 58 years) who underwent CCTA and invasive coronary angiography (ICA) were included in the study. Coronary atherosclerosis Plaque types are calcified, noncalcified and mixed. Using coronary angiography as the unit and ICA as the gold standard, correlation analysis and Bland-Altman analysis were used to evaluate the consistency of the two examinations in diagnosing coronary artery stenosis caused by the three plaques. Results: There were 49 cases (108 segments) with obvious coronary stenosis (≥50% stenosis). The coincidence of obvious stenosis of calcified plaque with two techniques was poor (r = 0.720, P <0.01) The consistency of plaque obviously stenosis was good (r = 0.895, r = 0.900, P <0.01). Conclusion: The accuracy of CCTA in diagnosing coronary artery stenosis caused by non-calcified and mixed plaques is good. The diagnosis of calcified plaque stenosis should be considered carefully.