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目的探讨电子束CT血管造影(EBA)评价冠状动脉狭窄中的误诊原因,以期提高成像成功率和诊断准确率。方法100例疑患冠心病者,先后行常规冠状动脉造影(CAG)及EBA冠状动脉成像,EBA图像按每例4支冠状动脉分别与CAG结果逐一对照,狭窄部位判断错误或狭窄程度判断误差>30%定为误诊,并进行统计学分析。结果100例共400支冠状动脉中有92支冠状动脉被EBA所误诊,误诊率为23%。误诊原因主要为呼吸心跳伪影、心律不齐、心率过快、延迟时间不准确、钙化斑遮挡等。其中左主干误诊率最低,为1.5%,其次为右冠状动脉4.8%、前降支5.5%,回旋支误诊率最高,为11.2%。结论了解EBA对冠状动脉狭窄的误诊原因可有针对性地提高成像成功率和诊断准确率。
Objective To investigate the misdiagnosis of coronary artery stenosis by electron beam computed tomography (EBA) in order to improve the imaging success rate and diagnostic accuracy. Methods One hundred patients with suspected coronary heart disease were examined by conventional coronary angiography (CAG) and EBA coronary angiography. EBA images were compared with CAG results by four coronary arteries in each case. The error of judgment of stenosis or the degree of stenosis> 30% as misdiagnosis, and statistical analysis. Results 92 coronary arteries in 400 coronary arteries of 100 cases were misdiagnosed by EBA with a misdiagnosis rate of 23%. The main causes of misdiagnosis of respiratory heartbeat artifacts, arrhythmia, heart rate too fast, the delay is not accurate, calcified plaque and so on. The left main misdiagnosis rate was the lowest, 1.5%, followed by the right coronary artery 4.8%, anterior descending artery 5.5%, the highest rate of misdiagnosis of supination, was 11.2%. Conclusion Understanding the misdiagnosis of EBA on coronary artery stenosis can improve imaging success rate and diagnostic accuracy.