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目的探讨冠状动脉多层螺旋CT血管造影(MSCTA)扫描技术的应用及其临床价值。方法86例受试者均行冠状动脉MSCTA,对照分析不同扫描条件下重建图像对冠状动脉的显示能力;并将25例冠心病患者的MSCTA结果与选择性冠状动脉造影(SCA)结果对照,分析冠状动脉及其分支的通畅性,狭窄发生的部位和严重程度,评价MSCTA的临床应用价值。结果(1)通过对照分析不同扫描条件下MSCTA重建图像对冠状动脉的显示结果,以心率控制在60次/min以下、注射流率3.0~3.5 ml/s、注射剂量120~150 ml、延迟22~25 s扫描时冠状动脉显示最佳;(2)以SCA为“金标准”,25例冠心病患者的冠状动脉支中,71支MSCTA显示无狭窄,其中68支显示正确;29支显示狭窄的动脉支中,19支显示正确。其阴性预测值和阳性预测值分别为87.2%和65.5%;敏感度、特异度和准确度分别为86.4%、87.2%、87.0%。结论MSCTA作为无创性检查,是评价冠状动脉病变的重要的筛选手段。
Objective To investigate the application and clinical value of multislice spiral CT angiography (MSCTA). Methods Eighty-six subjects underwent coronary artery MSCTA. The contrast-enhanced images were compared with those of the reconstructed images under different conditions. The MSCTA results of 25 patients with coronary artery disease were compared with those of selective coronary angiography (SCA) Coronary artery and its branches patency, stenosis occurred in the location and severity, evaluation of the clinical value of MSCTA. Results (1) Through the comparative analysis of the results of MSCTA reconstruction under different scanning conditions on the coronary arteries, the heart rate was controlled at 60 beats / min, the injection rate was 3.0-3.5 ml / s, the dosage was 120-150 ml, and the delay was 22 Coronary artery showed the best at ~ 25 s scan; (2) With SCA as the “gold standard”, 71 MSCTA showed no stenosis in coronary artery branch of 25 patients with coronary artery disease, of which 68 were correct; 29 showed stenosis Of the artery branch, 19 showed correct. The negative predictive value and positive predictive value were 87.2% and 65.5% respectively. The sensitivity, specificity and accuracy were 86.4%, 87.2% and 87.0% respectively. Conclusion MSCTA as a non-invasive examination is an important screening method for the evaluation of coronary artery disease.