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目的:探讨16层螺旋CT冠状动脉(简称冠脉)成像在冠心病诊断中的临床价值。方法:选取50例临床诊断或可疑冠心病患者行16层螺旋CT冠状动脉造影检查(MSCTCA),先行冠脉钙化积分平扫,然后行冠脉增强扫描,选取一组质量最佳的薄层图像行冠脉三维重建,分析MSCTCA对冠状动脉狭窄性病变的显示能力,并对冠脉支架显示及通畅性进行评价。结果:冠脉钙化积分与其狭窄程度呈正相关,中度以上狭窄的冠脉钙化积分值明显高于轻度狭窄,其间有统计学显著性差异(P<0.001)。MSCTCA对诊断有临床意义的冠脉中度以上狭窄的敏感度、特异度、诊断准确率、阳性预测值、阴性预测值分别约89.6%、93.9%、92.6%、86.7%、95.4%。MSCTCA对冠脉支架显示良好,检出5例9根支架,其中2根支架不通畅,出现支架内再狭窄。结论:16层螺旋CT冠脉成像安全、无创,对评价冠状动脉狭窄、支架开放及通畅性等方面有着较高的临床应用价值,可作为冠心病筛查的有效手段以及介入和手术治疗后的随访手段。
Objective: To investigate the clinical value of 16-slice spiral CT coronary angiography (CAD) in the diagnosis of coronary heart disease. Methods: Fifteen cases of clinically diagnosed or suspected CHD patients underwent 16-slice spiral CT coronary angiography (MSCTCA), followed by coronary artery calcification (CT) scan, coronary angiography and coronary angiography, and selected a group of the best quality thin-layer images Three-dimensional reconstruction of coronary artery was performed to analyze the ability of MSCTCA to display coronary artery stenosis and to evaluate coronary artery stent presentation and patency. Results: Coronary calcification score was positively correlated with the degree of stenosis. The score of coronary artery stenosis with moderate to severe stenosis was significantly higher than that with mild stenosis (P <0.001). The sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive value of MSCTCA for diagnosing moderately severe coronary lesions were about 89.6%, 93.9%, 92.6%, 86.7% and 95.4%, respectively. MSCTCA showed good coronary stent, 5 cases of 9 stent were detected, of which 2 stent is not smooth, there stent restenosis. Conclusion: 16-slice spiral CT coronary angiography is safe and noninvasive and has high clinical value in evaluating coronary artery stenosis, stenting openness and patency. It can be used as an effective means of coronary heart disease screening and after interventional and surgical treatment Follow-up means.