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纸质出版:2008
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秦将均,涂蓉,孙清荣.64层螺旋CT冠状动脉成像与冠状动脉造影对照分析[J].陆军军医大学学报(原第三军医大学学报),2008,30(19):1858-1861.
QIN Jiang-jun,TU Rong,SUN Qing-rong.Image quality evaluation of 64-slice spiral CT angiography in diagnosis of coronary artery disease[J].J Amry Med Univ (J Third Mil Med Univ),2008,30(19):1858-1861.
目的 探讨64层螺旋CT(64-slice spiral computed tomography,64-SCT)冠状动脉成像质量及其对冠状动脉疾病的诊断价值。 方法 回顾性分析39例同时经64-SCT冠状动脉成像和冠状动脉造影(coronary angiography,CAG)检查拟诊为冠心病的图像资料。 结果 39例507个冠状动脉节段中(每位患者分13个节段),64-SCT图像质量1、2、3级分别为185(36.5%) 、236(46.5%) 、86(16.9%) 个节段,其心率范围分别为(62±5)、(66±4)、(75±10)次/min。其中1、2级共421/507(即优良率达83.1%)个节段,能满足临床诊断;而86(86/507,16.9%)个节段因严重钙化51个(51/86,59.3%)或运动伪影35个(35/86,40.7%)无法对管腔进行评价。以冠状动脉造影(coronary angiography,CAG )为“金标准”,64-SCT冠状动脉成像诊断≥50% 狭窄总的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为89.8%、94.9%、93.3%、88.5%、95. 5%。 结论 64-SCT冠状动脉成像图像质量高,对冠状动脉疾病的诊断十分准确,可作为一种简便易行、安全可靠的无创性筛查冠心病的有效方法。
Objective To assessed the image quality and diagnostic value of the coronary artery diseases with 64-slice spiral computed tomography (64-SCT) angiography. Methods A retrospective image analysis of 39 patients who were diagnosed with coronary heart disease by both the 64-SCT and the invasive coronary angiography (CAG). Results In 507 coronary artery segments (13 coronary segments for each patient)
1-
2-
3-class image quality by 64-SCT were in 185 (36.5%)
236 (46.5%)
86 (16.9%) segments respectively
and the heart rate range was respectively 62±5
66±4 and 75±10 per minute. Totally 421/507 (83.1%) segments that were of 1-
2-class image quality
met the requirements of clinical diagnosis
whereas 86/507 (16.9%) segments could not be sufficiently evaluated because of severe calcifications (51/86
59.3%) and/or motion artifacts (35/86
40.7%). Taking CAG as the gold standard diagnostic technique for coronary heart disease
of the lesions≥50% stenosis by 64-SCT (without any exclusion criteria)
the overall sensitivity
specificity
accuracy
positive predictive value
and negative predictive value were 89.8%
94.9%
93.3%
88.5%
95.5%
respectively. Conclusion Our results indicate high diagnostic accuracy of coronary artery disease by 64-SCT compared to CAG. 64-SCT is a simple
convenient
safe and reliable
non-invasive effective method for diagnosis of coronary heart disease.
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