戴晓燕,向红,丁兆刚

• 1:新疆自治区人民医院心内科

摘要(Abstract)：

目的探讨64排螺旋CT冠状动脉成像在诊断冠心病中临床应用价值。方法回顾性分析2006年7月至2009年5月在新疆自治区人民医院心内科住院临床诊断或疑似冠心病患者病历资料120例,全部患者均行64排螺旋CT冠状动脉成像和选择性冠状动脉造影(CAG),前后时间不超过2周。按照美国心脏学会(AHA)冠状动脉分段法将冠状动脉分为16段,采用目测直径法判断冠脉狭窄程度,以CAG为诊断冠心病(CHD)的"金标准",计算64排螺旋CT检出中度及中度以上(≥50%)冠状动脉狭窄的敏感度、特异度、阳性预测值、阴性预测值和诊断符合率。结果总计1920冠脉节段中有1857(97%)个节段可以同时在CAG与多层螺旋CT(multisli cecomputed tomography,MSCT)上显示及评估。64排螺旋CT显示中度及中度以上冠状动脉狭窄的敏感度、特异度、阳性预测值、阴性预测值、诊断符合率分别为89%、98%、85%、98%、97%。结论 64排螺旋CT其对中度及中度以上的冠脉狭窄具有良好的诊断价值,基本能满足CHD的诊断需要,可作为CHD中危人群的一种初筛手段。

关键词(KeyWords)： 体层摄影术,螺旋计算机;冠状血管造影术;冠状动脉疾病

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 戴晓燕,向红,丁兆刚

参考文献(References)：

• [1]陆再英,钟南山.内科学.7版.北京:人民卫生出版社,2008:274.
• [2]Ropers D,Baum U,Pohle K,et al.Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction.Circulation,2003,107:664-666.
• [3]Windecker S,Maier-Rudolph W,Bonzel T,et al.Interventinal cardiology in Europe1995.Eur Heart,1999,20:484-495.
• [4]Ehara M,Surmely JF,Kawai M,et al.Diagnostic accuracy of64-slice computed tomography for detecting angiographically significant coronary artery stenosis in an unselected consecutive patient population:comparison with conventional invasive angiography.Circ J,2006,70:564-571.
• [5]李占全.冠状动脉造影与临床.沈阳:辽宁科学技术出版社,2003:85.
• [6]孙璐,霍建伟.64排螺旋CT冠状动脉造影技术及其临床应用.中国心血管病研究杂志,2006,4:381-382.
• [7]Becker CR,Knez A,Ohnesorge B,et al.Imaging of noncalcified coronary plaques using helical CT with retrospective ECG gating.AJR Am J Roentgenol,2000,175:423-424.
• [8]Schroeder S,Kopp AF,Baumbach A,et al.Noninvasive detection and evaluation of atherosclerotic coronary plaques with multislice computed tomography.J Am Coll Cardiol,2001,37:1430-1435.
• [9]Burgsthaler C,Beck T,Kuettner A,et al.Non-invasive evaluation of coronary artery bypass grafts using 16-row multi-slice computed tomography with188ms temporal resolution.Int J Cardiol,2006,106:244-249.
• [10]Martuscelli E,Romagnoli A,D'Eliseo A,et al.Evaluation of venous and arterial conduit patency by 16-slice spiral computed tomography.Circulation,2004,110:3234-3238.
• [11]Anders K,Baum U,Schmid M,et al.Coronary artery bypass graft (CABG)patency:assessment with high-resolution submillimeter 16-slice multidetector-row computed tomography(MDCT)versus coronary angiography.Eur J Radiol,2006,57:336-344.
• [12]Nieman K,Cademartiri F,Lemos PA,et al.Reliable non-invasive coronary angiography with fast submillimeter multislice spiral computed tomography.Circulation,2002,106:2051-2054.
• [13]Martuscelli E,Romagnoli A,D'Eliseo A,et al.Accuracy of thin-slice computed tomography in the detection of coronary stenoses.Eur Heart J,2004,25:1043-1048.
• [14]Becker CR,Knez A,Leber A,et al.Detection of coronary artery stenoses with multislice helical CT angiography.J Comput Assist Tomogr,2002,26:750-755.
• [15]Nieman K,Cademartiri F,Lemos PA,et al.Non-invasive coronary angiography with fast submillimeter multislice spiral computed tomography.Circulation,2002,106:2051-2054.
• [16]Hoffmann U,Nagurney JT,Moselewski F,et al.Coronary multidetector computed tomography in the assessment of patients with acute chest pain.Circulation,2006,114:2251-2260.
• [17]Raman SV,Shah M,McCarthy B,et al.Multi-detector row cardiac computed tomography accurately quantifies right and left ventricular size and function compared with cardiac magnetic resonance.Am Heart J,2006,151:736-744.
• [18]Kim SY,Seo JB,Do KH,et al.Coronary artery anomalies:classification and ECG-gated multi-detecter row CT findings with angiographic correlation.Radiographics,2006,26:317-333.
• [19]Budoff MJ,Cohen MC,Garcia MJ,et al.ACCF/AHA clinical competence statement on cardiac imaging with computed tomography and magnetic resonance.J Am Coll Cardiol,2005,112:598-617.
• [20]Weinreb JC,Larson PA,Woodard PK,et al.ACR clinical statement on noninvasive cardiac imaging.J Am Coll Radiol,2005,2:471-477.