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近十年来,由于16～64层CT的研发与应用使得CT冠状动脉成像(CTCA)由单纯科学研究转变到了临床应用。目前CTCA已广泛应用于冠状动脉粥样硬化性心脏病的诊断与随访、冠状动脉旁路移植术后及支架置入术后(直径3 mm以上的近端支架)的评估与随访。新近的Meta分析及多中心临床研究均认为CTCA具有较高阳性预测值及极高阴性预测值,更适用于可疑冠状动脉疾病(CAD)的排查。成本效益分析也显示建立在严格规范适应证与禁忌证的基础上使用CTCA可以大幅降低医疗成本。
In recent ten years, CT coronary angiography (CTCA) has been changed from simple scientific research to clinical application due to the development and application of 16 ~ 64-slice CT. At present, CTCA has been widely used in the diagnosis and follow-up of coronary atherosclerotic heart disease, assessment and follow-up after coronary artery bypass grafting and after stent implantation (proximal stent more than 3 mm in diameter). Recent meta-analysis and multicenter clinical studies have concluded that CTCA has a higher positive predictive value and a higher negative predictive value and is more suitable for the investigation of suspected coronary artery disease (CAD). Cost-benefit analysis also shows that using CTCA on the basis of strict regulatory indications and contraindications can significantly reduce the cost of healthcare.