64层螺旋CT冠状动脉成像对诊断冠心病的价值

摘要

目的 评估64层螺旋CT冠状动脉成像(64-SCTCA)的图像质量和诊断冠心病的准确性.方法 回顾性分析52例接受64层螺旋CT冠状动脉成像和选择性冠状动脉造影(SCAG)患者资料.通过主观评分的方式评估其64-SCTCA的图像质量,同时通过比较64-SCTCA与SCAG的一致性,评估64-SCTCA对冠心病诊断的准确性.结果 质量评估显示64-SCTCA的图像质量良好,平均(3.4±0.94)分,主干及近端分支成像清晰,远端也基本满意.64-SCTCA对于冠心病诊断的灵敏度96.8%,特异性95.5%,阳性预测值96.3%,阴性预测值95.2%;对中度以上冠状动脉狭窄准确性高,轻度冠脉狭窄准确性相对较差.结论 64层螺旋CT冠状动脉成像具有良好的图像质量和诊断准确性,有较好的临床应用价值.%Objective To investigate the image quality and the diagnostic accuracy of the 64 - slice spiral CT coronary angiography (64 - SCTCA) . Methods Fifty two patients who underwent 64 - SCTCA and selective coronary arteriograph ( SCAG) from Jan. 2009 to Aug. 2011 in our hospital were covered in this study. The image quality was evaluated by subjective scoring. And the diagnostic results by 64 - SCTCA were compared with the results by SCAG to evaluate its diagnostic accuracy. Results The image quality of 64 - SCTCA was observed as preferable image ( an average score of 3. 4 ± 0. 94 ) with a clear display of the main coronary arteries and their proximal branches, and with a satisfactory imaging of the distal branches. The evaluation of the diagnostic accuracy of 64 - SCTCA found a 96. 8% sensitivity, a 95. 5% specificity, a 96. 3% positive predictive value and a 95. 2% negative predictive value. In addition, the 64 - SCTCA was with a favorable diagnostic accuracy for detect coronary stenosis beyond moderate degree while its accurary for diagnose mild coronary stenosis was relative poor. Conclusion A preferable image quality and diagnostic accuracy of 64 - SCTCA were found, which suggest a good clinical usefulness.