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目的比较64层与16层螺旋CT冠状动脉成像的图像质量和分支显示率,评价64层螺旋CT诊断冠状动脉狭窄的准确性。方法对100例临床可疑冠心病患者(A组)行64层螺旋CT心电门控增强扫描,其中48例患者有常规冠状动脉造影做对照。对另外100例临床可疑冠心病患者(B组)行16层螺旋CT心电门控增强扫描。比较两组图像的质量评分和冠状动脉分支显示率。结果A组图像质量评分为(1.20±0.47)分,明显低于B组的(1.37±0.63)分(P<0.05)。两组冠状动脉近中段显示率差异无显著性(P>0.05),而远段和部分小分支显示率差异有显著性(P<0.05)。64层螺旋CT冠状动脉成像诊断冠状动脉≥50%狭窄的敏感性为94.9%(56/59),特异性为93.2%(124/133)。结论64层螺旋CT冠状动脉成像的图像质量和分支显示率较16层螺旋CT进一步提高,能够可靠诊断冠状动脉≥50%狭窄。
Objective To compare the imaging quality and branch display rate of 64-slice and 16-slice spiral CT coronary angiography and evaluate the accuracy of 64-slice spiral CT in diagnosing coronary artery stenosis. Methods 100 cases of clinically suspected coronary heart disease patients (group A) underwent 64-slice spiral CT enhanced gated ECG, including 48 patients with conventional coronary angiography as a control. Another 100 patients with clinically suspected coronary heart disease (B group) underwent 16-slice spiral CT ECG enhanced scan. The quality scores of the two groups of images and the rate of coronary artery branch display were compared. Results The image quality score of group A was (1.20 ± 0.47) points, which was significantly lower than that of group B (1.37 ± 0.63) points (P <0.05). There was no significant difference in the rate of proximal and middle coronary arteries between the two groups (P> 0.05), but there was significant difference between the distal segment and some small branches (P <0.05). The sensitivity of 64-slice spiral CT coronary angiography in the diagnosis of ≥50% coronary stenosis was 94.9% (56/59) and 93.2% (124/133). Conclusion The imaging quality and branch display rate of 64-slice spiral CT coronary angiography are more improved than 16-slice spiral CT, which can reliably diagnose≥50% coronary stenosis.