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目的评价CT冠状动脉造影(CTCA)、MR冠状动脉造影(MRCA)及冠状动脉血管造影(CAG)显示冠状动脉显著性狭窄的一致性。资料与方法搜集同期行CTCA、MRCA及CAG检查的患者30例,参照冠状动脉狭窄程度的评判标准,将冠状动脉显著性狭窄分为轻度狭窄(50%～75%)和重度狭窄(76%～100%),以CAG结果为标准,采用Kappa统计学方法,对比分析CTCA、MRCA显示冠状动脉显著性狭窄的一致性。结果 CTCA/MRCA评价冠状动脉轻度狭窄的敏感性、特异性及准确性分别为94.73%/85.40%、93.73%/86.14%及90.80%/84.52%,二者之间的一致性为88.86%(Kappa=0.163,P<0.05);评价重度狭窄的敏感性、特异性及准确性分别为95.87%/84.85%、94.54%/83.33%及90.46%/82.75%,二者之间的一致性为85.24%(Kappa=0.185,P<0.05)。结论对冠状动脉显著性狭窄的评价,CTCA优于MRCA,应作为首选方法,但二者有一定的互补作用。
Objective To evaluate the consistency of CT coronary angiography (CTCA), MR coronary angiography (MRCA) and coronary angiography (CAG) in demonstrating significant coronary stenosis. Materials and Methods Thirty patients who underwent CTCA, MRCA and CAG examination during the same period were enrolled in this study. According to the criteria of coronary artery stenosis, the significant stenosis of coronary artery was divided into mild stenosis (50% -75%) and severe stenosis (76% ~ 100%). According to CAG results, Kappa statistical method was used to compare CTCA and MRCA to show the consistency of significant coronary stenosis. Results The sensitivity, specificity and accuracy of CTCA / MRCA in assessing mild coronary stenosis were 94.73% / 85.40%, 93.73% / 86.14% and 90.80% / 84.52%, respectively, with a consistency of 88.86% Kappa = 0.163, P <0.05). The sensitivity, specificity and accuracy of evaluating severe stenosis were 95.87% / 84.85%, 94.54% / 83.33% and 90.46% / 82.75%, respectively, with a consistency of 85.24 % (Kappa = 0.185, P <0.05). Conclusions The evaluation of significant coronary stenosis, CTCA is superior to MRCA, should be the preferred method, but both have a certain complementarity.