冠状动脉CT血管成像对冠心病等危症患者诊断心肌缺血的价值
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2016年第5期
- 页码:
- 568-572
- 栏目:
- 临床研究
- 出版日期:
- 2016-04-25
文章信息/Info
- Title:
- Diagnostic value of coronary computed tomographic angiography in detection of myocardial ischemia in patients with coronary heart disease risk equivalents
- Author(s):
- LI Jian-long1; ZHANG Hong2; ZHANG Bian-hua2; HUANG Jin-xi2; CAO Xiang-hong2; SUN Shuai2; JIANG Feng1
- (1.Graduate School, Shanxi Medical University, Taiyuan 030001, Shanxi, China；
2.Department of Cardiology, People’s Hospital of Shanxi Province, Taiyuan 030012, Shanxi, China)
- 关键词:
- 冠状动脉CT血管成像; 负荷核素心肌灌注显像; 冠状动脉疾病; 冠状动脉疾病等危症
- Keywords:
- coronary computed tomographic angiography; myocardial perfusion imaging; coronary heart disease; coronary heart disease risk equivalents
- 分类号:
- R541.4
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 评价冠状动脉CT血管成像（CCTA）对冠心病等危症患者诊断心肌缺血的价值。方法 回顾性收集100例均接受了CCTA与负荷核素心肌灌注显像（MPI）的冠心病等危症患者。采用目测直径法对CCTA图像狭窄程度进行判定，冠状动脉狭窄分为<50%,50%~69%和≥70%。相应MPI图像上心肌节段的核素分布分为：灌注正常及灌注异常。结果 400条冠状动脉中，22条冠状动脉狭窄程度≥50%，其中10条（45%）相应的心肌供血区域在MPI图像上出现心肌灌注异常；378条冠脉血管狭窄程度<50%及正常，其中18条（4.8%）冠状动脉的心肌供血区域在MPI图像上出现心肌灌注异常。CCTA对评估心肌缺血诊断的灵敏度、特异度、阳性预测值和阴性预测值分别为36%、97%、45%和95%。结论 CCTA用于诊断冠心病等危症患者心肌缺血时，确定诊断性能较低，排除诊断性能较好。
- Abstract:
- AIM To evaluate the performance of coronary computed tomographic angiography (CCTA) in patients with coronary heart disease risk equivalents for diagnosis of myocardial ischemia. METHODSThis is a retrospective observational study, which included 100 patients with coronary heart disease risk equivalents. CCTA and MPI were conducted. The degree of coronary stenosis is divided by CCTA into the following groups: <50%, 50%-69%, ≥70%. Corresponding myocardial imaging on MPI is divided into normal perfusion and perfusion abnormalities. RESULTSAmong the total 400 coronary vessels, 22 coronary arteries were stenosed ≥50%, including ten with perfusion defect on MPI; 18/378 arteries in which coronary stenosis was<50% showed abnormal imaging on MPI. Sensitivity, specificity, positive predictive value and negative predictive value of CCTA in detecting myocardial ischemia was 36%, 97%, 45%, 95%, respectively. CONCLUSIONCCTA is a useful method for exclusion of myocardial ischemia in patients with coronary heart disease risk equivalents, but with a low diagnostic performance.
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备注/Memo
- 备注/Memo:
- 收稿日期：2015-08-05.
基金项目：山西省回国留学人员科研项目资助（2012-95）
通讯作者：张虹，主任医师，主要从事心血管内科研究 Email：Zhanghong625@hotmail.com
作者简介：李建龙，硕士生 Email：lijianlong19880126@163.com
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