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64层螺旋CT冠状动脉成像对不典型胸痛冠心病患者的诊断价值(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2008年第1期
页码:
91-94
栏目:
临床研究
出版日期:
2008-01-20

文章信息/Info

Title:
Diagnostic value of 64slice spiral computed tomography coronary angiography in coronary heart disease patients with atypical chest pain
作者:
周逸1; 陈曼华1; 王翔2; 熊才金1
武汉市中心医院：1.心血管内科，2.影像科， 湖北 武汉430014
Author(s):
ZHOU Yi1;  CHEN Manhua1;  WANG Xiang2;  XIONG Caijin1
1.Department of Cardiology, 2.Department of Radiology, Wuhan Central Hospital, Wuhan 430014, Hubei, China
关键词:
冠状动脉; 体层摄影术; 螺旋计算机; 血管造影术; 胸痛
Keywords:
coronary artery;  tomography;  spiral computed;  angiography;  chest pain
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 评价64层螺旋CT冠脉成像对不典型胸痛患者进行鉴别诊断的价值。方法 对72例不典型胸痛患者进行64层螺旋CT冠脉成像，再进行选择性冠脉造影（SCA），以SCA为标准对64层螺旋CT结果的准确性进行评价。结果 64层螺旋CT冠脉成像的敏感度、特异度和准确度分别为96%、79%和90%；64层螺旋CT对中度以上狭窄和轻度狭窄的诊断正确率分别为89%、58%(P<0.01)；64层螺旋CT对左回旋支和右冠状动脉病变的判断能力相对较差。结论 64层螺旋CT能够胜任不典型胸痛冠心病患者的筛查。
Abstract:
AIM To assess the value of differential diagnosis of 64slice spiral computed tomography (CT) coronary angiography in patients with atypical chest pain. METHODS Seventytwo patients underwent selective coronary angiography (SCA) after 64slice spiral CT coronary angiography. The accuracy of 64slice spiral CT was assessed by SCA. RESULTS The sensitivity, specificity and accuracy of 64slice spiral CT were 96%, 79% and 90% respectively. The correct ratio in significant stenoses (over 50% luminal narrowing) and nonsignificant stenoses (under 50% luminal narrowing ) of 64slice spiral CT were 89% and 58% respectively (P<0.01). The detection ability of 64slice spiral CT was relatively weak in left circumflex artery and right coronary artery. CONCLUSION The 64slice spiral CT can screen out the coronary heart disease patients with atypical chest pain.

参考文献/References

［1］ 俞高龙, 李海兵, 陆明华, 等. 多层螺旋CT量化冠状动脉钙化的评价［J］. 心脏杂志, 2004, 16(4): 335-336,338.

［2］ Nikolaou K, Rist C, Wintersperger BJ, et al. Clinical value of MDCT in the diagnosis of coronary artery disease in patients with a low pretest likelihood of significant disease［J］. AJR Am J Roentgenol, 2006, 186(6): 1659-1668.

［3］ Cademartiri F, Runza G, Belgrano M, et al. Introduction to coronary imaging with 64slice computed tomography［J］. Radiol Med, 2005, 110(12):16-41.

［4］ Mollet NR, Cademartiri F, van Mieghem CA, et al. Highresolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography［J］. Circulation, 2005, 112(15):2318-2323.

［5］ Raff GL, Gallagher MJ, O′Neill WW, et al. Diagnostic accuracy of noninvasive coronary angiography using 64slice spiral computed tomography［J］. J Am Coll Cardiol, 2005, 46(3): 552-557.

［6］ Pugliese F, Mollet NR, Runza G, et al. Diagnostic accuracy of noninvasive 64slice CT coronary angiography in patients with stable angina pectoris［J］. Eur Radiol, 2006, 16(3): 575-582.

［7］ 陈艳, 韩萍, 梁波, 等. 16层螺旋CT冠脉成像与DSA的对照研究［J］. 放射学实践. 2005, 20(3): 195-198.

［8］ 肖喜刚, 韩雪, 王雪红, 等. 多层螺旋CT冠脉成像在冠心病中的临床应用［J］. 中华放射学杂志. 2004, 38(9): 957-961.

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备注/Memo

备注/Memo:
收稿日期：2006-12-28.通讯作者：陈曼华，主任医师，教授，主要从事冠心病的介入治疗及基础研究Email: sjcmh@yahoo.com.cn 作者简介：周逸，主治医师，硕士 Email:zy1295090909@yahoo.com.cn
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