CAJ | 학술논문

目的探讨64排VCT冠状动脉造影检查对冠状动脉疾病的诊断价值.方法连续性收集173例临床怀疑及确诊冠心病的患者,先后行64排VCT冠状动脉成像(CTA)及冠脉造影(CAG),对所有病例使用GE AW4.3独立工作站提供的冠状动脉分析软件进行分析,主要进行了最大密度投影重建(MIP)、多平面重建(MPR)、容积重建(VR),将获得图像与冠脉造影图像进行对比分析.结果 173例中CTA显示的冠状动脉直径>1.5 mm的节段有746个,发现冠状动脉狭窄的敏感性为94.15%(193/204),特异性为95.90%(514/536),阳性预测值为89.77%(193/215),阴性预测值为97.90%(514/525).配对χ~2检验结果说明CTA和CAG 2种检查方法在诊断冠状动脉狭窄病变上无统计学差异(χ~2=1.58,P＞0.05),CTA与CAG在显示冠状动脉狭窄分级方面的一致性检验(Kappa值=0.890,P<0.001),提示CTA与CAG在显示与诊断冠状动脉狭窄分级方面具有良好的一致性.结论 64排VCT作为冠状动脉疾患的筛选、内支架术后及血管搭桥术后疗效随访有很大的临床应用价值.
목적 탐토64배VCT관상동맥조영검사대관상동맥질병적진단개치.방법 련속성수집173례림상부의급학진관심병적환자,선후행64배VCT관상동맥성상(CTA)급관맥조영(CAG),대소유병례사용GE AW4.3독립공작참제공적관상동맥분석연건진행분석,주요진행료최대밀도투영중건(MIP)、다평면중건(MPR)、용적중건(VR),장획득도상여관맥조영도상진행대비분석.결과 173례중CTA현시적관상동맥직경>1.5 mm적절단유746개,발현관상동맥협착적민감성위94.15%(193/204),특이성위95.90%(514/536),양성예측치위89.77%(193/215),음성예측치위97.90%(514/525).배대χ~2검험결과설명CTA화CAG 2충검사방법재진단관상동맥협착병변상무통계학차이(χ~2=1.58,P＞0.05),CTA여CAG재현시관상동맥협착분급방면적일치성검험(Kappa치=0.890,P<0.001),제시CTA여CAG재현시여진단관상동맥협착분급방면구유량호적일치성.결론 64배VCT작위관상동맥질환적사선、내지가술후급혈관탑교술후료효수방유흔대적림상응용개치.
Objective To evaluate the diagnostic value of 64-row VCT coronary angiography(CTA) in diagnosing coronary artery disease.Methods 64-row VCT coronary angiography(CTA) and cathter coronary angiography(CAG) were performed in 173 patients with suspected coronary artery disease.All images were analysed at GE AW4.3 workstation,the constructed images included maximum intensity projection(MIP),mlti-planar reconstruction(MPR) and volume rendering(VR).The results were compared with that of CAG.Results 746 segments of coronary artery with diameter ＞1.5 mm were showed by CTA in 173 patients.The sensitivity,specificity,positive predictive value and negative predictive value of the CTA in detecting coronary arterial stenosis were 94.15%(193/203),95.90% and 89.77% and 97.90% respectively.Statistical analysis using a 2-related χ~2 test showed that there were no obvious differences in diagnosing coronary arterial stenosis between CTA and CAG(χ~2=1.58,P＞0.05) and in evaluating the stenosis degree of coronary artery(Kappa=0.890,P＜0.001).Conclusion 64-row VCT has important clinical value in screening coronary arterial disease and in following-up post operational effectiveness of coronary stent implantation and vascular bypass.