16层螺旋计算机体层摄影术对冠状动脉疾病诊断价值.docVIP

16层螺旋计算机体层摄影术对冠状动脉疾病的诊断价值 　　　作者：李海文 作者单位：山西医科大学第二医院，山西 太原 030001 　　【摘要】 目的：探讨16层螺旋计算机体层摄影术(以下简称16层螺旋CT)冠状动脉成像技术的应用和临床价值。方法：200 例临床诊断或可疑冠心病的患者(29例行冠状动脉成形术及支架植入术，2 例行冠状动脉造影)做16层螺旋CT冠状动脉成像检查(回顾性心电门控，0.5S螺旋扫描)，分析16层螺旋CT对冠状动脉的显示能力，并分析管壁钙化和软性斑块，评价16层螺旋CT预测冠心病危险性的价值。结果：在21 例患者的152个节段(血管直径≥2 mm)中，CT图像能满足诊断要求的136节段(占83.9%)。对于CT图像能满足诊断要求的冠状动脉节段，16层螺旋CT显示中度或中度以上狭窄的敏感度和特异度分别为87.0%(27/31)和96.2%(101/105)。若将不能满足诊断要求的14个节段包括在内，则16层螺旋CT中度或中度以上狭窄的敏感度为80.0%(27/35)。此外，16层螺旋CT对冠状动脉钙化和软性斑块显示良好，对支架显示良好。结论：在冠状动脉中高度狭窄的诊断上，16层螺旋CT冠状动脉造影是一种有效的无创性诊断方法，可良好的显示冠状动脉软斑块和钙化，可作为冠状动脉疾病危险性的筛选方法。 　　【关键词】 冠状动脉疾病 多层螺旋计算机体层摄影术 心血管造影术 　　Diagnostic value of 16slice spiral computed tomography for detecting coronary artery disease 　　(The Second Hospital of Shanxi Medical University，Taiyuan 030001，China) 　　Abstract：Objective：To investigate the application and clinical value of Multislice spiral Xray computed tomography (MSCT，sixteenslice)coronary angiography.Methods：A total of 70 consecutive patients with known or suspected coronary artery disease(including 29 cases of coronary artery angioplasty and vessel stent，21 cases of coronary angiography)were studied by 16slice spiral CT(retrospectively ECGgating.0.5 s ratation).The coronary artery vessels displaying ability of 16slice spiral CT was analyzed.Whether there are calcifications and vulnerable plaques in vessel walls were analyzed either.To evaluate the value of 16slice spiral CT in prediction of gravity about coronary artery disease.Results：In the 152 coronary artery segments(vessel diameter≥2mm) of 16slice spiral CT in 21 patients，136 were judged to be evaluable by 16slice spiral CT(89.3%).The sensitivity and specificity for the detection of ≥50% stenosis were 87.0% and 96.2%，respectively.When 14 coronary artery segments jundged unevaluable were included in the analysis the sensitivity was 80.0%.Futhermore 16slice spiral CT shows a good method in displaying coronary artery calcification，vulnerable plaques and coronary artery