多排螺旋CT冠脉血管造影应用于冠状动脉狭窄的临床价值研究

目的：对比分析多排螺旋CT冠脉血管造影（CTA）和数字减影血管造影（DSA）评价冠状动脉狭窄的准确性及灵敏度，探讨CTA用于冠状动脉狭窄检查的临床价值。方法：收集2011年9月至2013年9月经我院门诊确诊或疑似冠心病的患者39例，进行CTA检查，并于检查前后两周内行DSA检查，将CTA及DSA的检查结果进行对比分析，同时对病变管腔的狭窄程度及检测的特异性和灵敏度进行比较。结果：39例患者共290支血管，CTA发现220支冠状动脉狭窄；DSA发现223支冠状动脉狭窄。以DSA为标准，CTA检查诊断中度以上冠状动脉狭窄的敏感性、特异性、阳性预测值、阴性预测值及准确度分别为：92．44％、96．15％、97．35％、93．46％、94．96％。结论：多排螺旋CT冠状动脉血管造影可清楚显示冠状动脉管壁增厚及狭窄情况、动脉壁的斑块和钙化等优势，是一种诊断冠状动脉疾病的理想的无创检测方法。

Clinical Value of CTA Applied in Coronary Artery Stenosis

Objective： Comparative analysis of multi slice spiral CT coronary angiography （CTA） and digital subtraction angiography （DSA） in the accuracy and sensitivity of evaluating coronary artery stenosis, in order to explore the clinical value of CTA for detecting coronary artery stenosis. Methods： 39 patients were diagnosed or suspected with coronary heart disease from 2011 September to 2013 September in our hospital. They were examined by CTA, and DSA within two week before or after the CTA examination. Then the CTA and DSA test results were compared and analyzed, the specificity and sensitivity of CTA and DSA of coronary artery were figured out. Results： 39 patients with 290 vessels, CTA found 220 coronary artery stenosis; DSA found 223 coronary artery stenosis. With DSA as the standard, the sensitivity, specificity, positive predictive value, negative predictive value and the detective accuracy of CTA detection is 92.44%, 96.15%, 97.35%, 93.46% and 94.96%. Conclusion： CTA can clearly show the changes of coronary artery wall thickening and stenosis, aortic wall plaque and calcification. It is an noninvasive method for the diagnosis of coronary artery disease.