【摘要】 目的 探讨256层螺旋CT冠状动脉造影(CTCA)对冠状动脉狭窄的临床诊断价值。方法 回顾性分析40例临床拟诊冠心病患者的256层螺旋CTCA资料,并以选择性冠状动脉造影(SCA)结果作为对照,分析256层螺旋CTCA诊断冠状动脉狭窄的敏感性、特异性、阳性预测值、阴性预测值和准确性,同时分析影响图像质量因素。结果 可评估冠状动脉155支,256层CT判断冠状动脉狭窄的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为:无狭窄为95.3%、97.1%、97.6%、94.3%、96.1%;轻度狭窄为66.7%、96.7%、70.5%、95.3%、86.4%;中度狭窄为77.8%、94.5%、75.0%、95.2%、91.6%;重度狭窄为83.3%、94.6%、74.1%、96.8%、92.9%。影响图像质量的重要因素包括运动伪影、管壁钙化斑块、高心率。结论 256层CTCA对冠状动脉狭窄的诊断准确性与SCA无显著性差异,256层CTCA具有更多的技术优势。更多还原

【Abstract】 Objective To evaluate the diagnostic accuracy of 256-slice spiral CT coronary angiography(CTCA) in the detection of coronary stenoses.Methods 256-slice CT coronary angiography of 40 cases who were clinically diagnosed or suspected of the coronary heart disease were analysed retrospectively,and compared with the results of selective coronary angiography(SC A).The factors of CTA image quality were analyzed.Results 155 segments of the coronary artery were evaluable.On 256-slice CT,the sensitivity,specificity,positive and negative predictive value,and accuracy for detecting of coronary artery stenosis were as following:95.3%,97.1 %,97.6%,94.3%,96.1% for without stenosis;66.7%,96.7%,70.5%,95.3%,86.4% for ≤50% stenosis;77.8%,94.5%,75.0%,95.2%,91.6% for 50%-75% stenosis;83.3%,94.6%,74.1 %,96.8%,92.9% for>75% stenosis.The important factors of CTA image quality included motion artifact,calcification and the high heart rate.Conclusion For diagnosing coronary artery stenosis,256-slice CT has no obervious difference compared with SCA.256-slice CT has more advantages in the technology.更多还原