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目的:评价40层螺旋CT(40 MSCT)冠状动脉成像诊断冠状动脉疾病的临床价值。方法:对使用40MSCT冠状动脉成像的40例患者同时实施选择性冠状动脉造影(CAG),以其结果为金标准,对40 MSCT显示的冠状动脉主支及主要分支情况进行狭窄程度评估。结果:40例患者可用于评估的冠状动脉489段血管中,共显示病变血管205段,其中83段得到CAG证实。22段血管MSCT诊断为狭窄而CAG显示正常,另15段CAG确诊存在病变而在MSCT尚未能显示。40 MSCT诊断冠状动脉病变的敏感性为91.8%,特异性为92.8%,阳性预测值为88.4%,阴性预测值为95%。经配对χ2检验,两种检查方法在发现冠状动脉疾病的方面差异无统计学意义(P<0.05)。结论:40 MSCT在显示冠状动脉病变时,具有较高的敏感性和特异性,对于病变程度的评估也比较准确,适合于临床怀疑冠心病的患者CAG前的筛选检查。
Objective: To evaluate the clinical value of 40-slice spiral CT (40 MSCT) coronary angiography in the diagnosis of coronary artery disease. Methods: Forty patients undergoing 40 MSCT coronary angiography were enrolled simultaneously with selective coronary angiography (CAG). The gold standard was used to assess the degree of stenosis of the major and major coronary arteries in 40 MSCT. RESULTS: Forty patients were included in the 489 coronary arteries for evaluation. Totally 205 vascular lesions were identified, and 83 of them were confirmed by CAG. Twenty-two vascular MSCT diagnosis of stenosis and CAG showed normal, the other 15 CAG confirmed the existence of lesions in the MSCT has yet to be displayed. The sensitivity and specificity of 40 MSCT for diagnosing coronary artery lesions were 91.8%, 92.8%, 88.4%, and 95%, respectively. Paired χ2 test, the two methods in detecting coronary artery disease was no significant difference (P <0.05). Conclusion: 40 MSCT has high sensitivity and specificity in displaying coronary artery lesions. It is also suitable for evaluating the degree of lesion and is suitable for pre-CAG screening in patients with clinically suspected coronary heart disease.