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目的:分析双源CT冠脉成像在冠脉粥样硬化性狭窄诊断中的价值。方法:以2014年5月至2016年5月我院初诊为“冠心病”的100例患者为研究对象,所有患者均行冠状动脉造影(CAG)和双源CT(DSCT)检查,比较两种检查方法在冠脉粥样硬化性显著性狭窄患者和不同冠脉血管(右冠脉、左冠脉主干、左前降支和回旋支)狭窄中的检查结果。结果:常规CAG检查共发现35例患者存在冠状动脉显著性狭窄,检出率为35%。DSCT共检出冠状动脉显著性狭窄患者45例,敏感度、特异度、阳性预测值和阴性预测值分别为100.0%,84.61%,77.78%和100.0%。一致性分析结果显示两种检测方法结果存在较强一致性,kappa=0.794(P<0.05)。100例患者中,常规CAG检查共发现显著性狭窄血管47条。DSCT共检出显著性狭窄血管39条,敏感度、特异度、阳性预测值和阴性预测值分别为93.62%、92.92%、63.77%和99.10%。一致性分析结果显示两种检测方法存在较强一致性,kappa=0.719(P<0.05)。右冠脉、左冠脉主干、左前降支和回旋支中,检查特异度和阴性预测值以左冠脉主干最高,敏感度和阳性预测值以左前降支最高。DSCT检查对于冠脉血管的完全闭塞、重度狭窄、中度狭窄和轻度狭窄的显示率高于CAG检查,但差异均无统计学意义(P<0.05)。结论:DSCT检查在冠脉粥样硬化显著性狭窄患者和狭窄冠脉血管(右冠脉、左冠脉主干、左前降支和回旋支)中具有较高的诊断价值。
Objective: To evaluate the value of dual-source CT coronary angiography in the diagnosis of coronary atherosclerosis. Methods: From May 2014 to May 2016, 100 patients with newly diagnosed coronary heart disease in our hospital were studied. All patients underwent coronary angiography (CAG) and double-source CT (DSCT) examination. Examination of two examinations in patients with significant coronary atherosclerosis and different coronary vessels (right coronary artery, left coronary artery, left anterior descending artery, and circumflex artery) in the presence of stenosis. Results: There were 35 patients with significant coronary stenosis found by routine CAG examination, the detection rate was 35%. Forty-five patients with significant coronary stenosis were detected by DSCT. The sensitivity, specificity, positive predictive value and negative predictive value were 100.0%, 84.61%, 77.78% and 100.0% respectively. Consistency analysis showed that there was a strong agreement between the two methods, kappa = 0.794 (P <0.05). Of the 100 patients, a total of 47 stenotic vessels were found in routine CAG examination. There were 39 stenotic vessels in DSCT. The sensitivity, specificity, positive predictive value and negative predictive value were 93.62%, 92.92%, 63.77% and 99.10% respectively. Consistency analysis showed strong consistency between the two assays, with kappa = 0.719 (P <0.05). Right coronary artery, left coronary artery, left anterior descending branch and circumflex artery, the specificity and negative predictive value of the left coronary artery was the highest, and the sensitivity and positive predictive value were the highest in the left anterior descending artery. DSCT showed a higher rate of complete occlusion of coronary vessels, severe stenosis, moderate stenosis and mild stenosis than CAG, but the difference was not statistically significant (P <0.05). Conclusion: DSCT has high diagnostic value in patients with significant coronary atherosclerosis and stenosis of coronary arteries (right coronary artery, left coronary artery, left anterior descending artery and circumflex artery).