16层螺旋CT冠脉造影对冠心病的诊断价值.DOCVIP

临床医学论文-16层螺旋CT冠脉造影对冠心病的诊断价值 　　　　　　　　　　　　作者：王喜卓,石奇松,王海涛,陈伟 【关键词】? 诊断 　　【摘要】? 目的? 探讨16层螺旋CT冠状动脉造影对冠心病的诊断价值。方法? 对75例临床怀疑冠心病、心绞痛的患者行16层螺旋CT冠状动脉造影和经皮选择性冠状动脉造影术。对16层螺旋CT显示冠状动脉狭窄和经皮选择性冠状动脉造影显示冠状动脉狭窄进行定量评价。以经皮选择性冠状动脉造影结果作为诊断的金标准。计算出16层螺旋CT冠状动脉成像对冠状动脉狭窄的诊断准确性指标。结果? 16层螺旋CT冠状动脉造影对照经皮选择性冠状动脉造影对冠状动脉中、重度狭窄显示的对照结果：敏感性83.33%、特异性91.40%、阳性预测值85.59%、阴性预测值89.95%、准确度83.33%。结论? 16层螺旋CT冠状动脉造影对冠心病具有良好的诊断价值，并可对冠状动脉形态学进行良好评价，从而进行介入治疗的筛选。但并不能完全取代传统的经皮选择性冠状动脉造影术。 　　【关键词】? 16层螺旋CT；回顾性心电门控；冠状动脉造影；冠心病；诊断??? 　　Diagnostic value of sixteen-detector row spiral CT coronary angiography in coronary artery diseases 　　　　【Abstract】? Objective? To evaluate the value of sixteen-detector row spiral CT in diagnosing coronary artery disease.Methods? 75 patients of suspected angina pectoris have undergone sixteen slice spiral CT coronary angiography and conventional percutaneous coronary angiography.Then coronary artery stenosis were quantitatively assessed.We considered the result of percutaneous coronary angiography as the gold standard and compared results of the two different diagnostic methods to determine the accuracy of 16 slice spiral CT.Results?Compared with percutaneous coronary angiography,the sensitivity of sixteen slice sparil CT in diagnosing moderate and severe coronary stenosis was 83.33%,and the specificness,positive predictive value,negative predictive value and degree of accuracy was 91.40%,85.59%,89.95% and 83.33% respectively.Conclusion?Sixteen slice spiral CT coronary angiography has clinical value in diagnosing coronary artery disease and can provide informations about coronary morphology for advanced interventional therapy.However,its diagnostic accuracy is limited and it cant replace theconventional percutaneous coronary angiography at present. 　　【Key words】? sixteen-detector row spiral CT;retrospective electrocardiogating;coronary arteriongraphy;coronary artery disease;diagnosis 　　近年来，由于多层螺旋CT的应用，无创性冠状动脉成像取得了重大进步。特别是16层螺旋CT的问世，多层螺旋CT（MSCT）对显示冠状动脉的狭窄，冠状动脉钙化以及粥样硬化软斑块具有较高的价值［1～3］。本课题旨