CAJ | 학술논문

目的：探讨64排螺旋多层CT延迟扫描对心肌梗死的诊断价值。方法选取30例临床怀疑心肌缺血性病变的患者进行常规64排多层螺旋CT冠状动脉造影，于5～10 min后进行延迟扫描。由2名经验丰富的医师在常规扫描及延迟扫描的容积数据进行双盲法诊断，然后将2名诊断医师诊断结果进行Kappa一致性分析。同时将常规扫描、延迟扫描与临床诊断进行敏感性及特异性进行比较。结果两名医师诊断结果在常规扫描时，具有较高的一致性（Kappa值为0.667，P＜0.05），而在延迟扫描时，具有高度的一致性（Kappa值0.889，P＜0.05）。常规组诊断急性心肌梗死（AMI）的敏感性及特异性66.7%及92.3%，而延迟扫描组诊断心肌梗死的敏感性及特异性为80.0%及96.2%。结论64排多层螺旋CT冠状动脉造影延迟扫描，能提高心肌梗死的检出率及影像医师诊断一致性。
목적：탐토64배라선다층CT연지소묘대심기경사적진단개치。방법선취30례림상부의심기결혈성병변적환자진행상규64배다층라선CT관상동맥조영，우5～10 min후진행연지소묘。유2명경험봉부적의사재상규소묘급연지소묘적용적수거진행쌍맹법진단，연후장2명진단의사진단결과진행Kappa일치성분석。동시장상규소묘、연지소묘여림상진단진행민감성급특이성진행비교。결과량명의사진단결과재상규소묘시，구유교고적일치성（Kappa치위0.667，P＜0.05），이재연지소묘시，구유고도적일치성（Kappa치0.889，P＜0.05）。상규조진단급성심기경사（AMI）적민감성급특이성66.7%급92.3%，이연지소묘조진단심기경사적민감성급특이성위80.0%급96.2%。결론64배다층라선CT관상동맥조영연지소묘，능제고심기경사적검출솔급영상의사진단일치성。
Objective The purpose of this study was to assess the value of delayed enhancement 64-detector row CT(DECT) for diagnosing acute myocardial infarct(AMI).Methods Thirty patients with suspected myocardial ischemia underwent coronary CT angiography(CTA).DECT was performed 5-10 minutes after intravenous contrast injection.The images were analyzed by two reviewers independently.The CTA and DECT were compared using k test.Results The consistency between the two observers was higher with the DECT(k=0.889,P<0.05)than that of CTA(k=0.667,P<0.05).The sensitivity(80.0%)and specificity(96.2%) of DECT for diagnosing AMI were also significantly higher(P<0.05)than those of CTA(66.7%,92.3%).Conclusions DECT can assess AMI accurately.