320排动态容积CT冠状动脉成像诊断冠状动脉狭窄的价值
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Diagnostic Value of 320-Slice Dynamic Volume CT in Assessment of Coronary Artery Stenosis
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    目的 以冠状动脉造影作为诊断冠状动脉狭窄的金标准,评价320排动态容积CT冠状动脉成像诊断冠状动脉狭窄的准确性。方法 应用320排动态容积CT对85例可疑冠心病患者行冠状动脉成像检查,同期行冠状动脉造影。结果 320排动态容积CT冠状动脉成像可获得较好的图像质量,可用于诊断冠状动脉狭窄。320排动态容积CT诊断冠状动脉轻度狭窄的敏感度为90.9%,特异度为99.2%,阳性预测值为89.6%,阴性预测值为99.3%,准确率为98.6%;诊断冠状动脉中度狭窄的敏感度为92.8%,特异度为98.9%,阳性预测值为90.9%,阴性预测值为99.2%,准确率为98.3%;诊断冠状动脉重度狭窄的敏感度为87.4%,特异度为98.8%,阳性预测值为89.2%,阴性预测值为98.6%,准确率为97.6%;诊断冠状动脉闭塞病变的敏感度为50.0%,特异度为99.9%,阳性预测值为66.7%,阴性预测值为99.8%,准确率为99.7%;诊断冠状动脉中度以上狭窄的敏感度为94.1%,特异度为97.2%,阳性预测值为89.2%,阴性预测值为98.5%,准确率为96.6%。结论 320排动态容积CT冠状动脉成像是一种无创、有效诊断冠状动脉狭窄的方法。

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    Aim To evaluate the diagnostic accuracy of coronary artery stenosis with 320-slice dynamic volume computed tomography (320-DVCT) in comparison of selective coronary angiography. Methods Eighty-five patients with suspected coronary artery disease underwent 320-DVCT coronary angiography and selective coronary angiography subsequently. All available coronary segments were included in the analysis, regardless of size or image quality. Lesion with >50% diameter stenosis were considered significant. Image quality was analyzed, and the sensitivity, specificity, positive and negative predictive value of mild, moderate, severe coronary stenosis, occlusive coronary artery and ≥50% stenosis were calculated. Results The images acquired from 320-DVCT were excellent and sufficient and can be used to evaluate coronary stenosis. The sensitivity, specificity, positive and negative predictive value of 320-DVCT for detecting severe coronary stenosis, occlusive coronary artery and ≥50% stenosis were 90.9%, 99.2%, 89.6%, 99.3% and 98.6%, respectively, by mild stenosis, 92.8%, 98.9%, 90.9%, 99.2% and 98.3%, respectively, by moderate stenosis, 87.4%, 98.8%, 89.2%, 98.6% and 97.6%, respectively, by severe stenosis, 50.0%, 99.9%, 66.7%, 99.8% and 99.7%, respectively, by occlusive coronary artery, 94.1%, 97.2%, 89.2%, 98.5% and 96.6%, respectively, by ≥50% coronary artery stenosis. Conclusions 320-DVCT is a new, noninvasive approach of assessing the stenosis of coronary artery and can provide accurate and reliable information.

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郝宝顺,刘 勇,周 彬,余舒杰,钱孝贤.320排动态容积CT冠状动脉成像诊断冠状动脉狭窄的价值[J].中国动脉硬化杂志,2013,21(01):74~78.

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  • 收稿日期:2012-03-22
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