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目的 以选择性冠脉造影(SCA)为标准判断双源CT(dual-sourcecomputed tomography,DSCT)冠脉造影的结果，分析影响DSCT冠脉造影诊断准确性的因素。方法 回顾性分析DSCT冠脉造影诊断为冠心病，后行选择性冠脉造影的患者156例，共分析1 369个节段，其中751个病变节段。绘制受试者工作特征曲线(ROC)，计算曲线下面积(AUC)值。比较病变不同钙化程度、病变血管直径、病变长度和病变血管分布对DSCT冠脉造影诊断准确性的影响。结果 重度钙化的AUC值明显低于中度钙化（0.571 vs. 0.718,P<0.05）和轻度钙化（0.571 vs. 0.843,P<0.01）。血管直径较小病变的AUC值明显低于血管直径较大病变（0.699 vs. 0.861,P<0.01）。回旋支病变的AUC值明显低于前降支病变（0.724 vs. 0.836,P<0.05）和右冠病变（0.724 vs. 0.853,P<0.05）。结论 重度钙化、血管直径较小和回旋支病变都是降低DSCT冠脉造影诊断准确性的因素。
Objective To evaluate the results of dual-source computed tomography (DSCT) coronary angiography by using selective coronary angiography (SCA) as the standard to analyze the factors influencing the diagnostic accuracy of DSCT coronary angiography. Methods A total of 156 patients with coronary artery disease undergoing coronary angiography and coronary angiography were retrospectively analyzed. A total of 1 369 segments were analyzed, including 751 lesions. The receiver operating characteristic curve (ROC) was plotted and the area under the curve (AUC) was calculated. To compare the different degree of calcification calcification, lesion vessel diameter, lesion length and lesion vascular distribution on DSCT coronary angiography diagnostic accuracy. Results AUC of severe calcification was significantly lower than moderate calcification (0.571 vs. 0.718, P & lt; 0.05) and mild calcification (0.571 vs. 0.843, P & lt; 0.01). The AUC of lesion with smaller vessel diameter was significantly lower than that with larger vessel diameter (0.699 vs. 0.861, P <0.01). The AUC of the circumflex lesion was significantly lower than that of the anterior descending branch (0.724 vs. 0.836, P & lt; 0.05) and the right coronary artery (0.724 vs. 0.853, P & lt; 0.05). Conclusions Severe calcification, small vessel diameter, and circumflexicular lesions are all factors that reduce the diagnostic accuracy of DSCT coronary angiography.