CAJ | 학술논문

目的评价128层螺旋CT(MSCT)冠状动脉成像诊断冠状动脉疾病的价值.方法对临床怀疑或确诊冠心病的非选择性连续78例患者进行128层MSCT冠状动脉成像,其中有15例患者既往置入冠状动脉支架.以选择性冠状动脉造影结果作为评价标准,探讨128层MSCT在诊断冠状动脉疾病及评价支架后再狭窄的临床价值.结果基于冠状动脉血管节段分析,879个冠状动脉节段中有821节段(93%)进入统计学分析,128层MSCT诊断冠状动脉病变的敏感性87%,特异性97%,阳性预测值83%,阴性预测值97%.对15例共置入22个支架的患者中,有4个(18%)支架MSCT图像显示支架伪影,图像模糊,未能判断支架内血管腔通畅情况,其余18个支架MSCT结果与选择性冠状动脉造影比较,MSCT诊断支架再狭窄的敏感性为100%,特异性77%,阳性预测值63%,阴性预测值100%.结论 128层MSCT冠状动脉成像对冠状动脉疾病的诊断和支架再狭窄的评价具有较高价值,可以作为一项无创检查技术用于对临床怀疑为冠心病的患者进行筛查.
목적 평개128층라선CT(MSCT)관상동맥성상진단관상동맥질병적개치.방법 대림상부의혹학진관심병적비선택성련속78례환자진행128층MSCT관상동맥성상,기중유15례환자기왕치입관상동맥지가.이선택성관상동맥조영결과작위평개표준,탐토128층MSCT재진단관상동맥질병급평개지가후재협착적림상개치.결과 기우관상동맥혈관절단분석,879개관상동맥절단중유821절단(93%)진입통계학분석,128층MSCT진단관상동맥병변적민감성87%,특이성97%,양성예측치83%,음성예측치97%.대15례공치입22개지가적환자중,유4개(18%)지가MSCT도상현시지가위영,도상모호,미능판단지가내혈관강통창정황,기여18개지가MSCT결과여선택성관상동맥조영비교,MSCT진단지가재협착적민감성위100%,특이성77%,양성예측치63%,음성예측치100%.결론 128층MSCT관상동맥성상대관상동맥질병적진단화지가재협착적평개구유교고개치,가이작위일항무창검사기술용우대림상부의위관심병적환자진행사사.
Objective To observe the diagnostic value of non-invasive 128-slice computed tomography coronary angiography(CTA)in comparison with invasive coronary angiography.Methods 128-slice CTA and invasive coronary angiography were performed in 78 unselected consecutive patients(63 patients with suspected coronary artery disease and 15 patients with previous coronary stenting,56 males,mean age 61±10 years)and ＞50% reduction of minimal lumen diameter was defined as significant coronary stenosis.Results Fifty-eight out of 879 segments(7%)from CTA were not assessable because of irreguldr rhythm,vessel calcification or tachycardia.Compared with invasive coronary angiography,segmentbased analysis from the 821 segments showed the sensitivity by CTA was 87%,specificity 97%,PPV 83% and NPV 97%.Four out of 22 stents implanted in 15 patients were not assessable by CTA because of poor image quality.Compared with invasive coronary angiography,the sensitivity of diagnosing in-stent restenosis by CTA was 100%,specificity 77%,PPV 63% and NPV 100% for the remaining 18 stents-Conclusions One hundred and twenty-eight-slice CTA has a high accuracy for detecting coronary artery disease and instent restenosis after coronary stenting and could be considered as a valuable noninvasive technique for screening coronary artery disease in suspected patients.