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目的:探讨多排螺旋CT(MSCT)冠状动脉成像质量及诊断价值。方法:115例临床疑似、确诊冠心病患者同时行MSCT、CAG检查。结果:冠脉左主干、前降支近中段、回旋支近段及右冠近段、远段成像质量优于其远段和侧枝(P=0.000)。MSCT对不同程度病变诊断情况有统计学差异(P=0.000)。MSCT、CAG冠脉狭窄程度Gensini量化评分正相关(rs=0.937,P=0.000),评判结果高度一致(K值0.813,P=0.000)。MSCT检测不同程度、不同节段冠脉病变的特异度和阴性预测值较高,分别为88.8%~99.0%、93.9%~99.7%、83.6%~100%、89.5%~100%;但敏感度、阳性预测值存在差异,分别为57.1%~96.5%、26.7%~92.6%、66.7%~100%、59.2%~100%。结论:MSCT对冠脉常见部位成像质量高,与CAG具有很高的诊断一致性,可作为临床冠心病筛查手段。
Objective: To investigate the quality and diagnostic value of multislice spiral CT (MSCT) coronary angiography. Methods: One hundred and fifteen patients with clinically suspected and confirmed coronary heart disease were examined with MSCT and CAG at the same time. Results: The imaging quality of left coronary artery, proximal middle part of anterior descending artery, proximal circumflex artery and proximal and distal coronary arteries were better than those of distal segment and collaterals (P = 0.000). MSCT of different degrees of disease diagnosis was statistically significant (P = 0.000). MSCT and CAG coronary stenosis were positively correlated with Gensini quantification score (rs = 0.937, P = 0.000). The results were highly consistent (K = 0.813, P = 0.000). The specificity and negative predictive value of MSCT in different degree and different segments of coronary artery disease were higher than that of MSCT, which were 88.8% -99.0%, 93.9% -99.7%, 83.6% -100% and 89.5% -100%, respectively. However, the sensitivity , The positive predictive values were different, ranging from 57.1% to 96.5%, 26.7% to 92.6%, 66.7% to 100% and 59.2% to 100%, respectively. Conclusion: MSCT has high imaging quality in common coronary sites and has high diagnostic consistency with CAG, which can be used as a clinical screening tool for coronary heart disease.