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目的评价64层螺旋CT(64SCT)冠状动脉成像检出冠状动脉狭窄性病变的准确性。方法连续30例临床怀疑冠心病的患者(男21例,女9例,平均年龄54.6岁)行64SCT冠状动脉成像检查,同期行选择性冠状动脉造影(SCA)。64SCT原始数据均行容积再现(VR)、曲面重组(CPR)、最大密度投影(MIP)及横断面重建。对2种方法评价冠状动脉结果进行对照研究,探讨64SCT冠状动脉成像检出冠状动脉狭窄病变的准确性。结果30例冠状动脉造影显示的396节段冠状动脉(直径≥2mm)图像中,64SCT提供优良图像可供分析为385节段,可评估率为97.2%。与SCA对照分析,评价冠状动脉狭窄(≥50%狭窄)的敏感性、特异性、阳性预测值以及阴性预测值分别为96.22%、94.56%、89.44%和96.88%。对冠状动脉≥50%狭窄的检出准确率为95.90%。结论64SCT对检出冠状动脉狭窄有较高的准确性,作为无创性检查方法,可用于冠心病的初步筛选。
Objective To evaluate the accuracy of 64-slice spiral CT (64SCT) coronary angiography in detecting coronary artery stenosis. Methods Thirty consecutive patients with clinically suspected coronary heart disease (21 males and 9 females, average age 54.6 years) underwent 64 SCT coronary angiography and selective coronary angiography (SCA) during the same period. The original data of 64SCT are volumetric reconstruction (VR), surface reconstruction (CPR), maximum density projection (MIP) and cross-sectional reconstruction. To compare the results of two methods in evaluating the coronary arteries, and to investigate the accuracy of 64SCT coronary angiography in detecting coronary artery stenosis. Results In the images of 396-segment coronary arteries (diameter≥2mm) displayed by coronary angiography in 64 patients, 64SCT provided excellent images for analysis of 385 segments with an assessable rate of 97.2%. Sensitivity, specificity, positive predictive value, and negative predictive value for the assessment of coronary artery stenosis (≥50% stenosis) were 96.22%, 94.56%, 89.44% and 96.88%, respectively, in comparison with SCA. Coronary ≥ 50% stenosis accuracy was 95.90%. Conclusion 64SCT has high accuracy in detecting coronary artery stenosis. As a noninvasive method, 64SCT can be used in primary screening of coronary heart disease.