| 林 豪,肖 波,刘一江,张 昊,魏 飞.双源CT冠脉成像在冠脉粥样硬化性狭窄诊断中的价值研究[J].,2017,17(20):3969-3972 |
| 双源CT冠脉成像在冠脉粥样硬化性狭窄诊断中的价值研究 |
| The Value of Coronary Artery Imaging with Dual-source CT in the Diagnose of Coronary Atherosclerotic Stenosis |
| 投稿时间：2016-11-15 修订日期：2016-11-30 |
| DOI：10.13241/j.cnki.pmb.2017.20.040 |
| 中文关键词: 冠状动脉狭窄 冠状动脉造影 双源CT冠脉成像 |
| 英文关键词: Coronary artery Stenosis Conventional coronary angiography Coronary artery imaging with dual-source CT |
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| 中文摘要: |
| 摘要 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。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical value of coronary artery imaging with dual-source CT (DSCT) in the diagnose of coronary atherosclerotic stenosis. Methods: 100 cases of patients who were firsty diagnosed as coronary heart diseases were selected and examined by DSCT and conventional coronary angiography (CAG), the imaging results were compared. Results: The positive rate of patients with significant coronary artery stenosis under CAG was 35%, and 45% under DSCT, the sensitivity, specificity, positive and negative predictive values of the DSCT were 100.0%, 84.61%, 77.78% and 100.0%, two kinds of detection methods existed strong consistency(kappa=0.794,P0.05). The positive rate of significant stenosis vessels under CAG was 47%, and 39% under DSCT, the sensitivity, specificity, positive and negative predictive values of the DSCT were 93.62%, 92.92%, 63.77% and 99.10%, two kinds of detection methods existed strong consistency(kappa=0.719, P＜0.05). The left main coronary artery had the highest specificity and negative predictive values, the left anterior descending had the highest sensitivity and positive predictive values. The rates of totally occluded, severe, moderate or mild stenosis with DSCT were higher than CAG, but no significant difference was found(P＜0.05). Conclusion: The DSCT had high diagnostic value in patients with significant coronary artery stenosis and different coronary blood vessels stenosis(right coronary artery, left main coronary artery, left anterior descending branch and maneuver). |
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