【摘要】 目的 探讨健康体检中多层螺旋CT冠脉成像(CTCA)对冠脉病变的价值。方法 对随机抽取的289例健康体检时进行CTCA的病例作冠脉钙化(CAC)的定性分析,然后分别对CAC阴性者和CAC阳性者的冠脉狭窄情况进行统计分析。结果 289名受检者中77例为CAC阳性,占26.64%;212例为CAC阴性,占73.36%。在CAC阳性者中检出冠脉狭窄57例,占74.03%;CAC阴性者中检出冠脉狭窄21例,占9.91%。结论 在健康体检时行胸部CT检查发现CAC阳性者,均应做CTCA检查;对CAC阴性者,如有高血糖、高血压、高血脂、吸烟者或有胸闷史者,也应做CTCA检查,以明确有无非钙化斑块的存在,避免非钙化斑块的漏诊。

    【关键词】 健康体检;多层螺旋CT;冠状动脉;钙化;血管造影

    【Abstract】 Objective To explore the value of multi-slice spiral CT coronary angiography (CTCA)for the coronary artery lesions in health examination.Methods Qualitative analysis of coronary artery calcification(CAC)was performed in 289 cases healthy subjects who were randomly selected,and then coronary stenosis in subjects with negative and positive CAC was analyzed statistically.Results Of 289 subjects,positive CAC were found in 77 cases,accounting for 26.64%;negative CAC in 212 cases,accounting for 73.36%.57 cases of coronary stenosis were detected in subjects with positive CAC,accounting for 74.03%;21 cases of coronary stenosis were detected in subjects with negative CAC,accounting for 9.91%.Conclusion All subjects with positive CAC found by chest CT scan should take CTCA examination.For subjects with negative CAC,if they have hyperglycemia,hypertension,hyperlipemia,medical history of smoking or dyspnea,CTCA is also need to be performed to make confirmation of non-calcified plaque and avoid the misdiagnosis. ......