Objective To evaluate and analyze the diagnostic accuracy of 256-slice computed topographic angiog-raphy (CTA) and coronary angiography (CAG) in patients with coronary artery disease (CAD). Methods One hundred and one patients (suspected CAD and confirmed CAD with re-examination) underwent the 256-slice CTA and CAG were includ-ed in this study. The coronary artery imaging data of 101 patients were retrospectively collected and analyzed. Calculations for accuracy were conducted on a segmental basis. A total of 1 313 comparable segments were evaluated. The accuracy of 256-slice CTA was evaluated in the diagnosis of moderate and severe stenosis of coronary artery(stenosis in segments of cor-onary artery≥50%). The values for diagnostic accuracy of 256-slice CTA were analyzed, including mild stenosis: <50%, moderate stenosis:50%~75%, severe stenosis:76%~100%and complete occlusion. Results The sensitivity of 256-slice CTA for diagnostic accuracy to coronary heart disease was 94.87%, and the specificity was 52.17%. The positive predictive value was 87.06%and the negative predictive value was 75.00%. The accuracy rates of 256-slice CTA for evaluating the cor-onary artery stenosis were:mild stenosis (44.23%), moderate stenosis (44.23%), severe stenosis (40.00%) and total occlusion of coronary artery (51.77%), respectively. Conclusion The diagnostic value of 256-slice CTA for the degree of coronary ar-tery stenosis is insufficient, which can be used as a potential alternative screening examination to detect coronary artery ste-nosis in suspected patients and a method of re-examination in low risk patients with CAD.%目的：评价256层螺旋CT冠脉成像（CTA）诊断及分级评价冠心病的临床应用价值。方法分析256层螺旋CTA和选择性冠脉造影术（CAG）检查的疑似或已确诊冠心病的101例患者资料。基于分血管节段后，共计1313段血管被评估。以CAG为金标准，评价CTA诊断冠心病（冠脉存在狭窄程度≥50%病变节段）的准确性；再分析CTA诊断冠脉分级评价（轻度狭窄：<50％；中度狭窄：50％~75％；重度狭窄：76％~100％，包括完全闭塞）的准确性。结果256层螺旋CTA诊断冠心病的灵敏度为94.87%、特异度为52.17%、阳性预测值为87.06%、阴性预测值为75.00%。256层螺旋CTA分级评价冠脉狭窄程度的准确性：轻度、中度、重度狭窄的灵敏度分别为44.23%、40.00%、51.77%。结论256层螺旋CTA判断冠脉狭窄程度能力仍显不足，但可作为可疑冠心病患者的筛查手段或低危冠心病患者的复查手段。
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