中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2012年
9期
1323-1325,后插2
,共4页
双源CT%冠状动脉造影%冠心病
雙源CT%冠狀動脈造影%冠心病
쌍원CT%관상동맥조영%관심병
dual-source computed tomography%coronary angiography%coronary heart disease
目的 探讨双源CT(DSCT)冠状动脉成像对冠状动脉疾病的诊断价值.方法 对36例疑有冠心病的患者冠状动脉进行DSCT和冠状动脉造影(CAG)检查,分析比较DSCT冠脉成像对冠状动脉疾病诊断的灵敏度、特异度、阳性预测值、阴性预测值及准确率.结果 36例DSCT冠脉成像与CAG相比较:诊断冠心病的敏感性100.00％,特异性66.67％,阳性预测值93.75％,阴性预测值100.00％,准确率97.20％；配对X2检验(x2 =0.500,P ＞0.05),一致性检验(Kappa值为0.768,P＜0.01).按病变血管计算,其诊断冠脉明显狭窄的敏感性95.24％,特异性96.08％,阳性预测值90.91％,阴性预测值98.00％,准确率95.83％；配对x2检验(McNemar检验)(X2=0.167,P＞0.05),一致性检验(Kappa值为0.899,P＜0.01).DSCT和CAG两种检查方法在评价冠心病及冠状动脉明显狭窄的血管上差异无统计学意义,具有很好的一致性.结论 双源CT对冠心病的诊断准确度接近选择性冠状动脉造影,DSCT与CAG具有较高的符合性与一致性,是一种无创、安全可靠的冠状动脉检查方法.
目的 探討雙源CT(DSCT)冠狀動脈成像對冠狀動脈疾病的診斷價值.方法 對36例疑有冠心病的患者冠狀動脈進行DSCT和冠狀動脈造影(CAG)檢查,分析比較DSCT冠脈成像對冠狀動脈疾病診斷的靈敏度、特異度、暘性預測值、陰性預測值及準確率.結果 36例DSCT冠脈成像與CAG相比較:診斷冠心病的敏感性100.00％,特異性66.67％,暘性預測值93.75％,陰性預測值100.00％,準確率97.20％；配對X2檢驗(x2 =0.500,P ＞0.05),一緻性檢驗(Kappa值為0.768,P＜0.01).按病變血管計算,其診斷冠脈明顯狹窄的敏感性95.24％,特異性96.08％,暘性預測值90.91％,陰性預測值98.00％,準確率95.83％；配對x2檢驗(McNemar檢驗)(X2=0.167,P＞0.05),一緻性檢驗(Kappa值為0.899,P＜0.01).DSCT和CAG兩種檢查方法在評價冠心病及冠狀動脈明顯狹窄的血管上差異無統計學意義,具有很好的一緻性.結論 雙源CT對冠心病的診斷準確度接近選擇性冠狀動脈造影,DSCT與CAG具有較高的符閤性與一緻性,是一種無創、安全可靠的冠狀動脈檢查方法.
목적 탐토쌍원CT(DSCT)관상동맥성상대관상동맥질병적진단개치.방법 대36례의유관심병적환자관상동맥진행DSCT화관상동맥조영(CAG)검사,분석비교DSCT관맥성상대관상동맥질병진단적령민도、특이도、양성예측치、음성예측치급준학솔.결과 36례DSCT관맥성상여CAG상비교:진단관심병적민감성100.00％,특이성66.67％,양성예측치93.75％,음성예측치100.00％,준학솔97.20％；배대X2검험(x2 =0.500,P ＞0.05),일치성검험(Kappa치위0.768,P＜0.01).안병변혈관계산,기진단관맥명현협착적민감성95.24％,특이성96.08％,양성예측치90.91％,음성예측치98.00％,준학솔95.83％；배대x2검험(McNemar검험)(X2=0.167,P＞0.05),일치성검험(Kappa치위0.899,P＜0.01).DSCT화CAG량충검사방법재평개관심병급관상동맥명현협착적혈관상차이무통계학의의,구유흔호적일치성.결론 쌍원CT대관심병적진단준학도접근선택성관상동맥조영,DSCT여CAG구유교고적부합성여일치성,시일충무창、안전가고적관상동맥검사방법.
Objective To explore the clinical value of dual-source CT(DSCT) in the diagnosis of coronary artery disease by comparing the result of DSCT and coronary angiography(CAG).Methods From July 2009 to August 2010,36 patients with suspected coronary hear disease underwent both DSCT coronary angiography(DSCTCA) and selective GAG examination.The results of DSCT coronary angiography were compared with CAG which was the gold standard of diagnosing coronary disease.The sensitivity,specificity,positive and negative predictive value,and accuracy of DSCT were evaluated.Results 144 coronary arteries were well evaluated of 36 cases.The sensitivity,specificity,positive and negative predictive value,and accuracy of DSCT in the diagnosis of coronary hear disease were 100.00％,66.67％,93.75％,100.00％ and 97.20％ respectively by the number of patients;The McNemar test showed no significant difference between two methods( x2 =0.500,P ＞0.05 ) with a higher diagnosis concordance (Kapp =0.768,P ＜0.01).By detecting moderate to severe coronary artery stenosis,the sensitivity,specificity,positive and negative predictive value,accuracy were 95.24％,96.08％,90.91％,98.00％,95.83％,respectively.The McNemar test showed no significant difference between two methods(x2 =0.167,P ＞0.05) with a higher diagnosis concordance ( Kapp =0.899,P ＜ 0.01 ).Conclusion DSCT has a diagnostic accuracy of coronary heart disease close to that CAG,especially in evaluating patients with moderate to severe coronary artery stenosis,it has high compliance and consistency with CAG.DSCT is a noninvasive,safe and reliable radiographic method.
