多排螺旋CT冠状动脉造影结合超声心动评价冠心病

目的评价多排探测器螺旋CT(multi-detect row computed tomography MDCT)冠状动脉造影结合超声心动图对冠心病的诊断价值.材料方法收集2002年-2003年间54例临床怀疑或确诊的冠心病患者.所有患者进行MDCT(美国GE公司四排探测器螺旋CT)冠状动脉造影及超声心动(美国惠普公司5500超声)检查,其中30例患者在CT和超声检查前后2周范围内进行了选择冠状动脉血管造影检查(selected coronary angiography SCA),并以此为金标准,对MDCTA结合超声心动图诊断冠心病的价值进行评估.结果 54例患者中,42例患者显示56支冠状动脉病变;超声心动发现左室舒张功能障碍24例.30例SCA显示25例患者38支冠状动脉病变(左冠32支,右冠6支).MDCT冠脉造影结合超声心动法与SCA法检查结果一致性为:92.86%,X2检验:X2＝0.5;0.5>P>0.25,无显著性差异.结论 MDCT冠脉造影扫描可以作为冠状动脉狭窄性冠心病的初步筛选手段,结合超声心动图有利于提高诊断准确性.

Evaluation of Coronary Heart Disease using MDCT Coronary Angiography Combined with Ultrasound

Objective To evaluate the diagnostic value of multi-detector row computed tomography (MDCT ) angiography combined with Ultrasound for coronary heart disease. Methods 54 patients with clinical suspected or confirmed coronary heart disease were studied in 2002-2003. All the patients were performed with MDCT (GE , four row scanners) and Ultrasound (Hp 5500). Among them, 30 cases were performed selected conventional angiography (SCA) of coronary artery during two weeks period of MDCT and Ultrasound examination. As a golden standard, SCA results were used to evaluate the value of the combined MDCT and Ultrasound examination. Results : 42 of 54 patients were found a coronary stenosis (56 segments) in MDCT and 24 patients among them shows a diastole dysfunction of left ventricle in Ultrasound. 25/30 cases SCA shows 38 coronary artery stenosis ( right 32 , left 6). The consistence rate of diagnostic results between MDCT angiography and Ultrasound with SCA is 98.26%, X2 test : X2 =0.5, 0.5>P>0.25, no significant difference. Conclusion: MDCT coronary angiography can be used as a screen method to detect the coronary heart disease. It is helpful to improve the diagnostic accuracy if combined with Ultrasound.