【摘要】 目的探讨Revolution CT冠状动脉成像与冠状动脉造影(CAG)评估冠状动脉狭窄的一致性。方法选取2016年8月～2018年8月我院收治的冠状动脉粥样硬化性心脏病(CHD)患者262例为研究对象,所有患者均行CAG和Revolution CT检查。以CAG为金标准,冠状动脉狭窄程度50%、75%为界,从冠状动脉血管和冠状动脉血管节段两个方面评价Revolution CT检查的敏感性、特异性、阳性预测值、阴性预测值及准确性。结果以冠状动脉狭窄程度50%、75%为界,从冠状动脉血管分析,Revolution CT与CAG诊断的Kappa值分别为0.851、0.885(P<0.05),Revolution CT诊断的灵敏度为92.59%、92.91%,特异度为92.53%、95.56%,准确度为92.56%、94.27%,阳性预测值为93.26%、95.16%,阴性预测值为91.78%、93.48%;从冠状动脉血管节段分析,Revolution CT与CAG诊断的Kappa值分别为0.828、0.826(P<0.05),Revolution CT诊断的灵敏度为93.47%、96.88%,特异度为93.97%、87.21%,准确度为93.59%、95.39%,阳性预测值为98.13%、97.67%,阴性预测值为80.96%、83.47%。结论 Revolution CT能较准确地诊断不同程度的冠状动脉狭窄,与CAG诊断有较好的一致性,但Revolution CT诊断可能出现假阳性结果,故目前临床中仍不能完全替代CAG检查。更多还原

【Abstract】 Objective To investigate the consistency of Revolution CT with coronary angiography(CAG)in the assessment of coronary artery stenosis.Methods 262 patients with CHD admitted to the Chongqing There Gorges Central Hospital from August 2016 to August 2018 were enrolled.All patients underwent CAG and Revolution CT.With CAG as the gold standard,the degree of coronary artery stenosis was 50% and 75%.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of Revolution CT were evaluated from two aspects:coronary artery and coronary vascular segment.Results Based on the coronary artery stenosis degree of 50%and 75%.From the perspective of coronary arteries,the Kappa values of Revolution CT and CAG were 0.851 and 0.885(P<0.05).The sensitivity of Revolution CT diagnosis was 92.59% and 92.91%.The specificity of Revolution CT diagnosis were92.53%and 95.56%.The accuracy of Revolution CT diagnosis were 92.56%and 94.27%.The positive predictive value of Revolution CT diagnosis were 93.26% and 95.16%.The negative predictive value of Revolution CT diagnosis were91.78% and 93.48%.From the perspective of coronary artery segment,the Kappa values of Revolution CT and CAG were 0.828 and 0.826(P<0.05),the sensitivity of Revolution CT diagnosis was 93.47%,96.88%,the specificity was93.97%,87.21%,the accuracy was 93.59%,95.39%,the positive predictive value was 98.13%,97.67%,and the negative predictive value was 80.96%and 83.47%.Conclusion Revolution CT can accurately diagnose different degrees of coronary artery stenosis,and has good consistency with CAG diagnosis.However,Revolution CT diagnosis may have false positive results,so it is still not completely replace CAG test in clinical practice.更多还原