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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2010年第2期

页码:

255-257

栏目:

临床研究

出版日期:

2010-03-04

文章信息/Info

Title:

Value of 64-slice spiral CT coronary angiography in assessment of coronary artery stenosis

作者:

郭进利¹; 高传玉²; 李牧蔚²; 杨蕾²

1.郑州大学第一附属医院心内科, 河南 郑州 450052；2.河南省人民医院心内科,河南 郑州 450003

Author(s):

GUO Jin-li¹;  GAO Chuan-yu²;  LI Mu-wei²;  YANG Lei²

1.Department of Cardiology, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, Henan, China; 2.Department of Cardiology, People’s Hospital of Henan Province, Zhengzhou 450003, Henan, China

关键词:

冠状动脉疾病; 冠状动脉造影术; 体层摄影术; X-线计算机; 多层螺旋CT成像

Keywords:

coronary disease;  computed tomography;  coronary angiography;  multiple-slice spiral computed tomography

分类号:

R541.4

DOI:

-

文献标识码:

A

摘要:

目的: 探讨64层螺旋CT冠状动脉成像（MSCTCA）判定冠状动脉狭窄的临床价值。方法: 回顾性研究在我科治疗并于2周内先后行MSCTCA和冠状动脉造影（CAG）的临床拟诊冠心病患者30(男21，女9)例；年龄49～74（62±7）岁，以CAG结果为准，计算评价指标。结果: 依节段计算的MSCTCA准确性，其灵敏度、特异度分别为50%、97%。若去除38个冠脉节段由于严重钙化而影响诊断的因素，则其灵敏度、特异度分别为74%、99%。结论: MSCTCA判断冠状动脉中、重度狭窄具有较高的准确性，对诊断冠心病尤其对筛选冠心病而言有较好的前景，但严重钙化病变影响冠状动脉狭窄程度的判断。

Abstract:

AIM: To compare the accuracy and limitations of 64-slice CT (MSCT) coronary angiography with invasive coronary angiography in the detection of significant coronary stenosis (≥50% lumen diameter narrowing). METHODS: Data were from 30 subjects ［21 males, 9 females, mean age (62±7) years, range: 49-74 years］ who had undergone MSCT and invasive coronary angiography within 2 weeks. Two experienced cardiologists analyzed the images of MSCT and invasive coronary angiography. RESULTS: For accuracy of coronary MSCT by each lesion segment, the average sensitivity was 50% and the average specificity 97%. Excluding the effect of 38 coronary segments with severe calcification, sensitivity and the specificity of MSCT were 74% and 99%, respectively. CONCLUSION: MSCT coronary angiography has a high accuracy rate and good potential for detection of coronary stenosis. However, severe calcification affects the accuracy in the detection of stenosis.

参考文献/References

［1］ Achenbach S, Giesler T, Ropers D, et al. Detection of coronary artery stenosis by contrast- enhanced, restrospectively electrocardiographically-gated, multislice spiral computed tomography［J］. Circulation, 2001, 103(21):2535-2538.

［2］ Ehara M, Surmely JF, Kawai M, et al. Diagnostic accuracy of 64-slice computed tomography for detecting angiographyically significant coronary artery stenosis in an unselected consecutive patient population［J］. Circ J, 2006, 70(5):564-571.

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

［4］ Gulati GS, Seth S, Kurian S, et al. Non-invasive diagnosis of coronary artery disease with 16-slice computed tomography［J］. Natl Med J India, 2005, 18(5):236-241.

［5］ Budoff MJ, Achenbach S, Fayad Z, et al. Task Force 12: training in advanced cardiovascular imaging (computed tomography): endorsed by the American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Atherosclerosis Imaging and Prevention, and Society of Cardiovascular Computed Tomography［J］. J Am Coll Cardiol, 2006, 47(4):915-920.

备注/Memo

备注/Memo:

收稿日期：2008-4-18.通讯作者：高传玉，主任医师，主要从事冠心病的研究Email:gaocy2000@yahoo.com.cn 作者简介：郭进利，主治医师，硕士生Email:guojinli4@126.com

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更新日期/Last Update: 2010-03-05