摘要
目的探讨64层螺旋 CT(MSCT)诊断伴钙化斑块的冠状动脉狭窄的正确性。方法60例患者同期行64层 MSCT 冠状动脉扫描和常规冠状动脉造影(CCA)。用 MSCT 的平扫图像行钙化积分测定,以 CCA 结果为金标准,得出64层 MSCT 诊断有意义病变(冠状动脉狭窄率≥50%)的正确性,并分析钙化对诊断正确性的影响。结果分析797个可以诊断的冠状动脉节段,得出 MSCT 诊断的敏感性为96%(174/182),特异性为98%(601/615),阳性预测值为93%(174/188),阴性预测值为99%(601/609)。对于钙化积分≥100分(Agatston 评分)的冠状动脉节段,MSCT 诊断的特异性为63%(12/19),阳性预测值为81%(30/37)。结论对于冠状动脉无钙化或者轻度钙化者,64层MSCT 可作为诊断冠心病的可靠手段应用于临床。对于严重钙化者,其诊断的特异性和阳性预测值明显下降。
Objective To investigate the diagnostic accuracy of 64-slice spiral computed tomography（MSCT） in detecting coronary artery lesions and to analyze the impacts of coronary artery calcium on its diagnostic accuracy. Methods Sixty patients underwent 64-MSCT coronary angiography and conventional coronary angiography （CCA）. Calcium scoring was estimated on plain scans. The diagnostic accuracy of MSCT to detect significant lesions （ ≥ 50% ） was evaluated referring to quantitative coronary angiography （QCA）. The impacts of coronary artery calcium on the diagnostic accuracy was analyzed. Results A total of 797 segments were diagnositc. The overall sensitivity, specificity, positive predictive value and negative predictive value of 64-MSCT were 96% （174/182） , 98% （601/615）, 93% （174/188） , and 99% （601/609） , respectively. When calcium score ≥ 100 （ Agatston score） , the specificity and positive predictive value of 64-MSCT was 63% （12/19） and 81% （30/37）, respectively. Conclusion In patients with no or mild coronary calcification, the 64-MSCT coronary angiography had a reliable detection of coronary artery stenoses. But severe calcification in coronary artery may degrade diagnostic specificity and positive predictive value of MSCT coronary angiography.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2007年第10期1023-1027,共5页
Chinese Journal of Radiology
