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目的评估基层医院多层螺旋CT(MSCT)行冠状动脉检查的准确性。方法收集在基层医院已行MSCT检查,提示冠状动脉狭窄患者90例,再经北京阜外心血管病医院行冠状动脉造影确诊,采用Kappa检验比较2种检查方法结果的一致性。结果 MSCT诊断冠心病的准确率为88.9%。诊断冠状动脉狭窄程度的准确率39.0%,诊断左前降支、左回旋支和右冠状动脉的准确率分别为45.5%、37.5%和33.3%。在诊断心肌肌桥两者无一相符,诊断钙化准确率较高为80.0%。MSCT检查冠状动脉各节段的狭窄与冠状动脉造影一致性差。左主干、左前降支、左回旋支和右冠状动脉的Kappa值均<0.75。结论基层医院MSCT诊断冠心病的准确率较高,但在诊断血管狭窄程度上准确率较低。
Objective To evaluate the accuracy of multislice spiral CT (MSCT) coronary angiography in primary hospitals. Methods Totally 90 patients with coronary artery stenosis were examined by MSCT in the primary hospitals. Coronary angiography was performed in Beijing Fuwai Cardiovascular Hospital. Kappa test was used to compare the consistency of the two methods. Results The accuracy of MSCT in diagnosing coronary heart disease was 88.9%. The accuracy rate of diagnosing coronary stenosis was 39.0%. The accuracy of diagnosing left anterior descending branch, left circumflex branch and right coronary artery were 45.5%, 37.5% and 33.3% respectively. In the diagnosis of myocardial bridge of the two without a match, the diagnosis of calcification higher accuracy was 80.0%. MSCT examination of coronary stenosis of each segment and coronary angiography poor consistency. Left main, left anterior descending branch, left circumflex branch and right coronary artery Kappa values were <0.75. Conclusion The accuracy of MSCT in diagnosing coronary heart disease in primary hospitals is high, but the accuracy of MSCT in diagnosing coronary artery stenosis is low.