CAJ | 학술논문

背景:许多初步研究结果:表明,16层螺旋CT对冠状动脉狭窄的显示具有较高的准确件.目的:通过与冠状动脉造影对比评价多层螺旋CT诊断冠状动脉中、重度狭窄的准确性和局限性.设计、时间及地点:金杯准对照观察的临床诊断实验,于2005-06/2006-03在首都医科大学宣武医院心脏科完成.对象选择2005-06/2006-03首都医科大学宣武医院心内科收治的1个月内先后行64层螺旋CT和冠状动脉造影检查的临床诊断或可疑冠状动脉硬化性心脏痫患者28例.方法:采用国际上通用的目测直径法.对选择性冠状动脉造影或多层螺旋CT显示冠状动脉狭窄进行定量评价.分别对28例患者的280个节段进行分析.主要观察指标:多层螺旋CT冠状动脉成像对冠状动脉狭窄的真阳性、真酬性、假阳性、假阴性以及灵敏度、特异度、准确度、刚性预测值、阴性预测值.结果:纳入的28例患者全部进入结果:分析.依节段计算多层螺旋CT的准确性,其灵敏度、特异度、阳性预测值和阴性预测值分别为46.5%,97.6%,86.8%和84_3%.若去除其中31个冠状动脉节段由于严重钙化向影响诊断的因素,则多层螺旋CT的诊断灵敏度、特异度、阳惟坝测值和阴性预测分别为66.7%,98.6%,90.3%和93.6%.结论:多层螺旋CT冠状动脉成像是一种简便易行、安全可靠、风险小的无创性检查,对诊断冠状动脉硬化性心脏病尤其针对筛选冠状动脉硬化性心脏病而言有较好的前景,但也有一定局限性.
배경:허다초보연구결과:표명,16층라선CT대관상동맥협착적현시구유교고적준학건.목적:통과여관상동맥조영대비평개다층라선CT진단관상동맥중、중도협착적준학성화국한성.설계、시간급지점:금배준대조관찰적림상진단실험,우2005-06/2006-03재수도의과대학선무의원심장과완성.대상선택2005-06/2006-03수도의과대학선무의원심내과수치적1개월내선후행64층라선CT화관상동맥조영검사적림상진단혹가의관상동맥경화성심장간환자28례.방법:채용국제상통용적목측직경법.대선택성관상동맥조영혹다층라선CT현시관상동맥협착진행정량평개.분별대28례환자적280개절단진행분석.주요관찰지표:다층라선CT관상동맥성상대관상동맥협착적진양성、진수성、가양성、가음성이급령민도、특이도、준학도、강성예측치、음성예측치.결과:납입적28례환자전부진입결과:분석.의절단계산다층라선CT적준학성,기령민도、특이도、양성예측치화음성예측치분별위46.5%,97.6%,86.8%화84_3%.약거제기중31개관상동맥절단유우엄중개화향영향진단적인소,칙다층라선CT적진단령민도、특이도、양유패측치화음성예측분별위66.7%,98.6%,90.3%화93.6%.결론:다층라선CT관상동맥성상시일충간편역행、안전가고、풍험소적무창성검사,대진단관상동맥경화성심장병우기침대사선관상동맥경화성심장병이언유교호적전경,단야유일정국한성.
BACKGROUND: Primary studies suggest that coronary artery stenosis is highly exactly shown by 16-slice spiral CT coronary artery imaging.OBJECTIVE: To compare the accuracy and limitation between coronary angiography and multi-slice computed tomography (MSCT) coronary artery imaging to diagnose moderate and severe coronary artery stenosis. DESIGN, TIME AND SETTING: Clinical diagnostic study based on gold standard, which was carried out in the Department of Cardiology, Xuanwu Hospital, Capital Medical University from June 2005 to March 2006. PARTICIPANTS: Twenty-eight patients with suspected coronary arteriosclerotic heart disease were examined by 64-slice spiral CT coronary artery imaging and coronary artery angiography during the 1-month hospitalization in the Department of Cardiology, Xuanwu Hospital, Capital Medical University from June 2005 to March 2006. METHODS: 280 segments of 28 patients were quantitatively analyzed coronary artery stenosis by selective coronary artery angiography and multi-slice spiral CT imaging based on eye-measurement diameter method. MAIN OUTCOME MEASURES: True positive, true negative, false positive, false negative, sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of coronary artery stenosis were measured by multi-slice spiral CT imaging.RESULTS: All 28 patients were included in the final analysis. Multi-slice spiral CT imaging showed that the sensitivity, specificity, positive predictive value, and negative predictive value were 46.5%, 97.6%, 86.8%, and 84.3%, respectively. If excluding the effect of 31 coronary segments with severe calcification, the sensitivity, specificity, positive predictive value and negative predictive value were 66.7%, 98.6%, 90.3% and 93.6%, respectively.CONCLUSION: Multi-slice spiral CT imaging is simple, reliable, noninvasive and safe; moreover, it has a good potential for diagnosing especially excluding coronary arteriosclerotic heart disease, but still some limits.