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选择2004-10/2005-07在徐州医学院附属医院心内科住院的临床诊断或疑诊冠心病的患者33例作16层螺旋CT冠状动脉成像。男14例,女19例;年龄范围43～81岁。采用回顾性心电门控、0.4s/周扫描,其结果与冠状动脉造影对照。共评价33例患者的396个冠状动脉节段,可用于诊断者344个节段,约占86.9%。对符合评价条件的冠状动脉节段16层螺旋CT诊断≥50%狭窄的敏感性、特异性、阳性预测值、阴性预测值分别为:87.7%,94.3%,78.0%,97.0%。根据冠状动脉造影结果,冠心病26例,非冠心病7例,16层螺旋CT发现冠心病患者含钙化节段59个,无钙化节段215个,非冠心病受检者中检出含钙化节段3个,无钙化节段67个。两者比较差异显著(P<0.005)。16层螺旋CT显示冠状动脉狭窄具有较高的敏感性、特异性和准确性,可以作为筛选冠状动脉病变的影像学诊断方法。16层螺旋CT可发现冠心病与非冠心病冠状动脉钙化的差异,钙化广泛者应建议冠状动脉造影检查。
Thirty-three patients with clinically diagnosed or suspected CHD who were hospitalized in Department of Cardiology, Xuzhou Medical College Affiliated Hospital from October 2004 to Jul 2005 were selected for 16-slice spiral CT coronary angiography. There were 14 males and 19 females, ranging in age from 43 to 81 years. Retrospective ECG gating, 0.4s / week scan, the results of coronary angiography control. A total of 396 coronary artery segments of 33 patients were evaluated, which could be used in 344 segments of the diagnosis, accounting for 86.9%. The sensitivity, specificity, positive predictive value and negative predictive value of 16-slice CT coronary angiography in the diagnosis of coronary artery segments meeting the evaluation criteria were 87.7%, 94.3%, 78.0% and 97.0%, respectively. According to the results of coronary angiography, coronary heart disease in 26 cases, non-coronary heart disease in 7 cases, 16-slice spiral CT found coronary heart disease patients with calcification segment 59, non-calcification segment 215, non-coronary heart disease patients were detected with calcification 3 segments, 67 segments without calcification. The difference was significant (P <0.005). 16-slice spiral CT shows high sensitivity, specificity and accuracy of coronary artery stenosis and can be used as a diagnostic imaging method for screening coronary artery lesions. 16-slice spiral CT coronary artery disease can be found in coronary heart disease and non-coronary calcification differences, calcification should be recommended coronary angiography.