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【目的】探讨电子束CT(EBCT)造影对冠状动脉各节段病变诊断价值的差异。【方法】同期行选择性冠状动脉造影和EBCT冠状动脉造影检查的患者38例,对照选择性冠状动脉造影的结果计算EBCT造影检测冠状动脉各节段狭窄病变的准确性。【结果】①选择性冠状动脉造影可清晰显影的332个节段中,EBCT造影可清晰显示和评价占264段(79.5%),68段(20.5%)显影不清。左主干和前降支可评价节段的比例显著高于左回旋支和右冠状动脉(P<0.05或0.01),同一支血管中近段可评价的比例显著高于远段(P<0.05或0.01)。②EBCT造影检测节段病变总的敏感性、特异性、准确性、阳性和阴性预测值分别为81.0%、95.9%、93.6%、79.1%和96.4%;EBCT造影对诊断左主干和左前降支各节段病变的价值高于左回旋支和右冠状动脉,检测冠状动脉近段病变的价值高于远段。【结论】电子束CT冠状动脉造影对冠状动脉的评价和病变检测受解剖部位和血管大小的影响,检测左主干和左前降支各节段病变的价值高于左回旋支和右冠状动脉,对冠状动脉近段病变的诊断价值高于远段。
【Objective】 To investigate the diagnostic value of electron beam computed tomography (EBCT) on the segmental coronary lesions. 【Methods】 Thirty-eight patients undergoing selective coronary angiography and EBCT coronary angiography during the same period were enrolled in this study. The accuracy of EBCT contrast-enhanced coronary angiography was compared with that of selective coronary angiography. 【Results】 Among the 332 segments with selective coronary angiography, EBCT can clearly show and evaluate 264 segments (79.5%) and 68 segments (20.5%) clearly. The proportions of the left main and anterior descending branches were significantly higher than those of the left circumflex branch and the right coronary artery (P <0.05 or 0.01), and the proportions of proximal and distal branches were significantly higher in the same branch than in the distal segment (P <0.05 or 0.01). ② The overall sensitivity, specificity, accuracy, positive and negative predictive value of EBCT were 81.0%, 95.9%, 93.6%, 79.1% and 96.4% respectively. The EBCT angiography was more effective in diagnosing the left main and left anterior descending The value of segmental lesion is higher than that of left circumflex branch and right coronary artery. The value of detecting proximal coronary artery lesion is higher than that of distal segment. 【Conclusion】 Coronary angiography by electron beam computed tomography (CT) coronary angiography and lesion detection are influenced by anatomical location and vessel size. The value of detecting lesion in the left main and left anterior descending branches is higher than that of left circumflex branch and right coronary artery Coronary artery proximal lesions higher than the diagnostic value.