摘要
目的在病例非选择性的基础上，将多层螺旋CT冠状动脉血管造影（Cq＇A）与侵人性冠状动脉造影（ICA）相比，评估其准确性及敏感性，并分析其伪影产生的原因以及解决方法。方法对45名可疑冠心病患者在7～10d先后予以CTA及ICA检查，将二者相比。结果对45名患者从节段水平分析其敏感性、特异性、阳性预测值、阴性预测值为：85．0％，99．1％，93．1％，98．0％；患者水平分别为：84．8％，75．0％，90．3％，64．2％。结论CTA诊断准确性高，尤其表现在节段水平对于阴性预测值判断，从患者水平分析，其诊断价值下降，显示对于高度危险患者，常规行CTA检查，并不能从中获益。由于患者自身或扫描的原因会出现影响图像诊断的伪影，对这些伪影的成因及特点进行分析有助于提高CTA的成功率及避免假阳性的诊断。
Objective Multislice Computed tomography coronary angiography （CTA） is in- creasingly used as an alternative to diagnostic coronary angiography for visualizing coronary arteries. The major limitation of recently published studies, aside from being monocentric in nature and the patients included, is the selection of patients. These studies did not provide any answers for patients who are seen daily in cardiology consultation. The purpose of this study wis to determine the diag- nostic accuracy of CTA as compared with coronary angiography on a population of average patients who were not selected. To investigate the causes and strategies of artifact and pitfalls of coronary artery imaging. Methods Forty- five patients with suspected coronary artery disease underwent CTA followed by invasive coronary angiography 7 with in to 10 days. The diagnostic accuracy de- tection d significant coronary stenoses （greater than 50 % stenoses in arteries greater than 1.5ram in diameter） was determined and the two techniques were compared. Results The sensitivity, specificity, positive and negative predictive value of CTA in detecting significant coronary stenoses were 85.0 %, 99.1%, 93.1% and 98.0 % in per - segment evaluation. During the per - patient evaluation, the efficacy of CTA dropped with the values being 84.8 %, 75.0 %, 90.3 % and 64.2 % re- spectively. Conclusion The use of CTA results in excellent diagnostic accuracy and in anincreased negative predictive value for detecting significant coronary stenoses in per - segment analysis. Perpatient analysis significantly reduced the value of scanning, demonstrating that patients with a high probability of coronary artery disease do not benefit from this type of non - invasive approach. By reasons of patients themselves orscan protocols , the artifacts will appear . To analyze the causes and features of these artifacts will be helpful to elevate the achievement ratio and avoid false positive diagnosis.
出处
《实用临床医药杂志》
CAS
2010年第3期50-53,共4页
Journal of Clinical Medicine in Practice
