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目的:通过对64排螺旋CT(MSCT)冠状动脉造影与选择性冠状动脉造影检测冠状动脉病变(冠状动脉狭窄≥50%)的对比分析,探讨64层螺旋CT评估冠状动脉病变诊断的准确性。方法:回顾性收集2007年12月～2008年10月于我院同期接受64层螺旋CT冠状动脉成像和常规经皮冠脉造影的112位冠心病患者的影像资料,以常规冠脉造影为参考标准,对2种检查方法的结果进行对比分析,评估64层螺旋CT冠脉造影对冠状动脉病变诊断的准确性。结果:按常规冠脉造影计算,112例患者共发现374处病变用于评价,MSCT造影检测冠脉病变总的准确性为90.6%,假阳性率和假阴性率分别为4.3%和5.1%;其中MSCT检测为假阴性均发生在左回旋支和右冠远段,假阳性均为冠状动脉伴有钙化。结论:64排螺CT冠状动脉造影检测冠状动脉病变诊断的准确性较高,但血管解剖和冠状动脉钙化可能会影响其对冠状动脉病变的评价和检测。
OBJECTIVE: To compare the accuracy of 64-slice spiral computed tomography (CT) in the diagnosis of coronary artery lesions by comparing the results of 64-slice spiral CT (MSCT) coronary angiography and selective coronary angiography in detecting coronary artery lesions (≥50% coronary stenosis). Methods: The data of 112 coronary heart disease patients undergoing 64-slice spiral CT and conventional percutaneous coronary angiography at the same period of our hospital from December 2007 to October 2008 were retrospectively collected. The conventional coronary angiography Standards, the results of two kinds of inspection methods were compared to assess the accuracy of 64-slice spiral CT coronary angiography in the diagnosis of coronary lesions. Results: According to the conventional coronary angiography, 374 lesions were found in 112 patients for evaluation. The overall accuracy of MSCT angiography was 90.6%, and the false positive rate and false negative rate were 4.3% and 5.1% respectively. Among them, the false negative results of MSCT were found in the left circumflex branch and the right crown, and the false positives were all accompanied by calcification in the coronary artery. Conclusion: The accuracy of 64-slice spiral CT coronary angiography in the diagnosis of coronary artery lesions is high, but the vascular anatomy and coronary artery calcification may affect the evaluation and detection of coronary artery lesions.