ISSN 1004-4140
CN 11-3017/P

心律不齐患者64层螺旋CT冠脉成像的临床应用

Clinical Application of 64-Slice Spiral CT for Detecting Coronary Artery Disease in Patients with Arrhythmia

  • 摘要: 目的: 与DSA结果进行对照,评价MSCTA对心律不齐患者冠脉病变的诊断价值。方法: 收集2009年1月至2010年11月在煤炭总医院临床诊断和怀疑冠心病的心律不齐患者31例,在一个月内分别完成MSCT和DSA检查。以DSA为参考标准,评价MSCTA在心律不齐患者中冠脉病变的诊断价值。结果: 30例图像(96.77%,30/31)均能达到诊断标准,MSCTA对于检出冠脉狭窄<50%的敏感性88.46%、准确性87.74%、特异性87.50%、阳性预测值69.70%、阴性预测值84.34%;检出冠脉狭窄≥50%的敏感性98.51%、准确性91.51%、特异性89.22%、阳性预测值75.00%、阴性预测值88.78%。对MSCTA与DSA检出狭窄<50%、≥50%的冠状动脉总节段数进行χ2检验,χ2=0.879,P>0.05,二者无差异显著性;并对两种检查方法在检出冠脉狭窄方面进行量化分析具有明显的相关性(r=0.763,P<0.01)。结论: 采用适当的扫描和后处理技术,MSCTA评估心律不齐患者冠脉狭窄病变的敏感性较高,与DSA相比具有较高的一致性,并能鉴别斑块性质、诊断心肌桥,满足临床冠心病筛查的需要。

     

    Abstract: Objectives: To evaluate the diagnostic value of MSCT for detecting coronary artery disease in patients with arrhythmia by compared with DSA.Methods: During January 2009 to November 2010,we collected the data of 31 patients with arrhythmic who were suspected or to have coronary artery disease to accomplishing MSCT and DSA in Coal General Hospital.The results were compared with DSA.Result: The MSCT enabled the visualization of the entire coronary tree with diagnostic image quality in 30 of the 31 patients(96.77%,30/31);The MSCT had a sensitivity of 88.46%,accuracy of 87.74%,Specificity of 87.50%,positive predictive value of 69.70%and negative predictive value of 84.34%for detecting less than 50%stenosis;while it had also a sensitivity of 98.51%,accuracy of 91.51%,Specificity of 89.22%,positive predictive value of 75.00%and negative predictive value 88.78%for detecting more than or equal 50%stenosis.Eventually statistical analysis usingχ2 test showed no statistically significant difference between MSCT and DSA,χ2=0.879,p>0.05.The overall Pearson's correlation coefficient between the degree of stenosis detected by DSA and MSCT(r=0.763,p<0.01).Conclusion: Adopted appropriate measures to scanning and after processing,MSCT has excellent sensitivity for assessment coronary artery stenosis,and while has high concordance as compared with DSA,moreover it also can identify the property of plaque and detecting myocardial bridge to content the needs of clinical.

     

/

返回文章
返回