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目的探讨16层螺旋CT冠状动脉造影(MSCTCA)对冠脉显示和判断冠脉狭窄度的可行性。方法85例患者均进行16层螺旋CT冠脉成像与选择性冠脉造影(SCA)检查,分析MSCTCA对冠状动脉各节段的显示能力,判断冠脉的狭窄度并与SCA结果进行比较,分析其诊断准确性。结果16层螺旋CT冠状动脉成像对冠脉的总显示率为96.7%,MSCTCA显示未见狭窄冠脉血管477段,轻度狭窄119段,中度狭窄191段,高度狭窄41段,总诊断准确率为92.9%,正常血管段的准确率为99.2%,轻度狭窄的诊断准确率为65.1%,以有临床意义的中高度狭窄(即管腔狭窄≥50%)作为阳性标准,MSCTCA阳性诊断准确率为93.1%,灵敏度为90%,特异度为97.3%,MSCTCA诊断与SCA结果具有较高一致性,两者间无统计学显著性差异。结论MSCTCA可获得较好的冠脉图像并准确判断其狭窄度,是冠心病筛查以及诊治后随访的一种有效安全、无创的血管成像技术。
Objective To investigate the feasibility of using 16-slice spiral CT coronary angiography (MSCTCA) to display coronary artery stenosis and determine the degree of coronary artery stenosis. Methods Totally 85 patients underwent 16-slice spiral CT coronary angiography and selective coronary angiography (SCA). The ability of MSCTCA to display coronary artery segments was analyzed. The coronary stenosis was evaluated and compared with SCA results Its diagnostic accuracy. Results The 16-slice spiral CT coronary angiography showed 96.7% of the total coronary arteries. MSCTCA showed no 477 stenosis coronary arteries, 119 mild stenoses, 191 moderate stenoses and 41 high stenoses. The total diagnosis was accurate The positive rate was 92.9%, the accuracy rate of normal vascular segment was 99.2%, the accuracy rate of mild stenosis was 65.1%. The clinically significant stenosis (ie, stenosis≥50%) was used as the positive standard. MSCTCA positive diagnosis The accuracy was 93.1%, the sensitivity was 90% and the specificity was 97.3%. There was no significant difference between MSCTCA and SCA. Conclusion MSCTCA can obtain better coronary angiography and accurately determine its stenosis. It is an effective, safe and noninvasive vascular imaging technique for coronary heart disease screening and follow-up after diagnosis and treatment.