16排螺旋CT在冠状动脉病变诊断中的应用The investigation of the 16-slice CT angiography in diagnosis of the coronary artery disease
杨俊娟,高澜,邱建星,陈明,洪涛,张宝娓,霍勇
摘要(Abstract):
目的探讨和评价16排螺旋CT在冠状动脉病变诊断中的价值。方法总结2003年8月至2004年9月于北京大学第一医院行16排螺旋CT冠状动脉成像检查的90例患者的资料,其中男性63例,年龄(67±9)岁。患者均于检查前后两周时间内进行了传统冠状动脉造影术。以冠状动脉造影结果为“金标准”,分析16排螺旋CT冠状动脉成像检查的灵敏度、特异度、阳性预测值及阴性预测值,并初步分析引起检查结果偏差的原因。结果16排螺旋CT冠状动脉成像检查共评价了冠状动脉直径>1.5mm的节段1267个,与冠状动脉造影“金标准”相比,16排螺旋CT冠状动脉成像检查诊断冠状动脉分支血管中度以上狭窄(>50%)的灵敏度为75.43%,特异度为95.88%,阳性预测值为74.58%,阴性预测值为96.01%,准确度为93.05%。结论16排螺旋CT冠状动脉成像检查可较为准确地诊断冠状动脉狭窄,可作为冠状动脉粥样硬化病变的筛查手段,是一种安全、有效、无创的检查方法。
关键词(KeyWords): 体层摄影术,X线计算机;冠状血管造影术;冠状动脉疾病
基金项目(Foundation):
作者(Author): 杨俊娟,高澜,邱建星,陈明,洪涛,张宝娓,霍勇
参考文献(References):
- [1]Nieman K,Cademartiri F,Lemos PA,et al.Reliable noninvasive coronary angiography withfast submillimeter multislice spiral comput-edtomography.Circulation,2002,106:2036-2038.
- [2]Rydberg J,Liang Y,Teague SD.Fundamentals of multichannel CT.Radiol Clin NAm,2003,41:465-474.
- [3]Martuscelli E,Romagnoli A,D’Eliseo A,et al.Accuracy of thin-slice computedtomographyinthe detection of coronary stenoses.Eur Heart J,2004,25:1043-1048.
- [4]王照谦.多层螺旋CT在冠心病诊断中的价值//胡大一,马长生.心脏病学实践2004.北京:人民卫生出版社,2004:160-170.
- [5]Flohr T,Kuttner A,Bruder H,et al.Performance evaluation of a multi-slice CTsystemwith16-slice detector andincreased gantryrota-tion speed for isotropic submillimeter imaging of the heart.Herz,2003,28:7-19.
- [6]Kopp AF,Schroeder S,Kuettner A,et al.Non-invasive coronary angiography with highresolution multidetector-rowcomputedtomogra-phy:results in102patients.Eur Heart J,2002,23:1714-1725.
- [7]Ohnesorge B,Flohr T,Fischbach R,et al.Reproducibility of coro-nary calciumquantificationinrepeat examinations withretrospectively ECG-gated multisection spiral CT.Eur Radiol,2002,12:1532-1540.
- [8]Ulzheimer S,Kalender WA.Assessment of calciumscoring perfor-mance in cardiac computed tomography.Eur Radiol,2003,13:484-497.
- [9]Schoenhagen P,et al.Non-invasive assessment of plaque morphology andremodeling in mildly stenotic coronary segments:comparison of 16-slice computed tomography and intravascular ultrasound.Coron Artery Dis,2003,14:459-462.