[1]马党捐 ,康彦智 ,柴茂林.64排128层螺旋CT冠状动脉成像在冠心病患者诊断中的价值研究*[J].陕西医学杂志,2019,(5):624-627.
　MA Dangjuan,KANG Yanzhi,CHAI Maolin..Value analysis of 64rows 128slice spiral CT coronary angiography in the diagnosis of patients with coronary heart disease[J].,2019,(5):624-627.
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64排128层螺旋CT冠状动脉成像在冠心病患者诊断中的价值研究*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年5期
页码:
624-627
栏目:
临床研究
出版日期:
2019-05-05

文章信息/Info

Title:
Value analysis of 64rows 128slice spiral CT coronary angiography in the diagnosis of patients with coronary heart disease
文章编号:
DOI: 10.3969/j.issn.10007377.2019.05.023
作者:
马党捐1 ; 康彦智1 ; 柴茂林
1.陕西省第二人民医院影像科（西安 710005）;2.陕西省第二人民医院放射科（西安 710005）
Author(s):
MA Dangjuan; KANG Yanzhi; CHAI Maolin.
Imaging Department of Shaanxi Second Provincial Hospital(Xi’an 710005)
关键词:
冠心病; 诊断; CT 冠状动脉成像; 冠状动脉造影术; 敏感度; 特异度
Keywords:
Key words Coronary heart disease; Diagnosis; CT coronary angiography; Coronary angiography; Sensitivity; Hex
分类号:
R541.4
文献标志码:
A
摘要:
摘 要 目的：研究64排128层螺旋CT（64SCTA）冠状动脉成像在诊断冠心病（CHD）患者中的应用价值。方法：选取CHD患者60例，所有患者均经64SCTA诊断后，1周内进行CAG检查。测定不同冠状动脉段分支斑块的CT值，并根据CT值的不同将斑块进行分类，包括软斑块、钙化斑块、纤维斑块和混合性斑块。分别对64SCTA和CAG检测结果下冠状动脉的狭窄程度进行评估，包括正常、轻度狭窄、中度狭窄和重度狭窄。分析LM、LCX、LAD和RCA部位CAG和64SCTA诊断敏感度和特异度，并以CAG的诊断结果为金标准，计算64SCTA诊断方法的诊断敏感度和特异度。结果：不同冠状动脉分支中斑块数量差异有统计学意义（P＜0.05），其中LAD中斑块数量最多（38.73%），LM中斑块数量最少（7.04%）。冠状动脉中不同斑块性质分布差异有统计学意义（P＜0.05），64SCTA和CAG对冠状动脉不同狭窄程度分析结果比较，差异无统计学意义（P＞0.05），64SCTA和CAG 对LM、LCX、LAD和RCA对不同狭窄程度诊断结果比较，差异无统计学意义（P＞0.05）。两种诊断方法对不同冠状动脉段的诊断敏感度和特异度经比较，差异无统计学意义（P＞0.05）。以CAG为金标准，64SCTA的诊断阳性率为94.59%，特异度96.06%。结论：64SCTA诊断CHD狭窄程度具有较高的诊断敏感度和特异度，且能够用于评价斑块的分布和性质，可应用于CHD患者的筛查和诊断中，为一种诊断CHD可靠的无创性检测方法。
Abstract:
Abstract Objective：To analysis the application of 64rows 128slice spiral CT(64SCTA) coronary angiography in the diagnosis of patients with coronary heart disease.Methods：60 patients with CHD were selected. All patients were diagnosed by CASC after 1 week after diagnosis by 64SCTA. CT values of branch plaques in different coronary segments were measured, and plaques were classified according to CT values, including soft plaques, calcified plaques, fibrous plaques, and mixed plaques. Coronary artery stenosis was assessed for 64SCTA and CAG, including normal, mild stenosis, moderate stenosis, and severe stenosis. The diagnostic sensitivity and specificity of CAG and 64SCTA in LM, LCX, LAD and RCA sites were analyzed, and the diagnostic sensitivity and specificity of the 64SCTA diagnostic method were calculated based on the gold standard of CAG diagnosis. Results：The number of plaques in different coronary artery branches was significantly different (P＜0.05), with the largest number of plaques in LAD (38.73%) and the least number of plaques in LM (7.04%). The distribution of different plaques in coronary arteries was significantly different (P＜0.05). There was no significant difference between 64SCTA and CAG in the analysis of different degrees of coronary artery stenosis (P＞0.05). 64SCTA and CAG were used to compare the results of different stenosis diagnosis of LM, LCX, LAD and RCA, the difference was not statistically significant (P＞0.05). The diagnostic sensitivity and specificity of the two diagnostic methods for different coronary segments were compared, and the difference was not statistically significant (P＞0.05). With CAG as the gold standard, the diagnostic positive rate of 64SCTA was 94.59% and the specificity was 96.06%.Conclusion：64SCTA has a high diagnostic sensitivity and specificity for the diagnosis of CHD stenosis, and can be used to evaluate the distribution and nature of plaque. It can be applied to CHD screening and diagnosis of patients, and which is a〖LM〗 reliable method for detecting CHD.

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备注/Memo

备注/Memo:
*陕西省社会发展科技攻关项目(2012SF105)
更新日期/Last Update: 2019-05-07