双源 CT 对冠状动脉狭窄及斑块性质的应用价值

摘要

目的：探讨双源CT对冠状动脉狭窄及不同性质冠状动脉斑块的诊断价值。方法：对50例临床确诊及拟诊冠心病患者行双源CT冠状动脉成像（CCTA）检查及冠状动脉造影（CCA），以CCA结果为参考标准，评估双源CT对不同性质斑块所致冠状动脉狭窄的特异度、敏感度、阳性预测值、阴性预测值及准确性，分析狭窄程度与斑块成分间的相关性。结果：与CCA对照，50例患者中，双源CT对诊断冠状动脉狭窄的特异度、敏感度、阳性预测值、阴性预测值依次如下：轻度狭窄分别为98．9％、46．7％、77．8％、95．8％；中度狭窄分别为97．6％、71．0％、84．6％、94．8％；重度狭窄分别为96．6％、96．4％、96．4％、98．6％。误诊冠状动脉狭窄共20支，诊断符合率为89．8％。对非钙化性斑块所致管腔狭窄的诊断符合率达84．3％，高于钙化性斑块（76．9％）。结论：双源CT冠状动脉成像能够有效判断冠状动脉狭窄程度及斑块成分。%Objective: To discuss the diagnosis value for coronary artery of different components of plaque and stenosis by dual-source computed tomography coronary artery imaging.Method:A total of 50 pa-tients diagnosed with coronary heart disease underwent dual-source computed tomography coronary artery ( CCTA) imaging and coronary angiography( CCA) .The specificity,sensitivity, positive predictive value,neg-ative predictive value,and accuracy for the quantitative detection of stenosis assessed.Result:In the 50 pa-tients,The specificity,sensitivity, positive predictive value,negative predictive value and accuracy for the de-tection of coronary artery stenosis assessed with dual-source CT were respectively:for<50 stenosis,98.9%, 46.7%,77.8%,95.8%;for 50 ~74 stenosis,97.6%,71.0%,84.6%,94.8%;for≥75 stenosis,96.6%、96. 4%、96.4%、98.6%.Comparing with CCA,misdiagnosis was observed in 20 of 196 arteries with dual-source CT coronary.The luminal stenosis caused by non calcified plaque diagnosis coincidence rate was 84.3%, which higher than that of calcified plaque ( 76.9%) .Conclusion: Dual-source CT coronary artery imaging can effectively detect the coronary plaque composition and accurate judgment of the degree of coronary artery stenosis.