64排螺旋CT对隐匿型冠心病冠状动脉狭窄及斑块性质的诊断价值(1)
[摘要] 目的 探究64排螺旋CT对隐匿型冠心病及斑块性质的诊断价值。 方法 病例整群选取于该院2012年2月—2014年8月经64排螺旋CT做冠状动脉成像检查的140例隐匿型冠心病患者，参照DSA检查结果，比较64排螺旋CT对病患狭窄冠状动脉及斑块性质的检出情况。结果 64排螺旋CT对隐匿型冠心病患者冠状动脉狭窄程度及单支与多支冠状动脉狭窄的检出例数与对照组比较均无明显差异，比较差异无统计学意义(P>0.05)；在隐匿型冠状动脉病变中，主见轻度狭窄及单支冠状动脉出现狭窄病患；64排螺旋CT对隐匿型冠心病血管中软斑块、硬斑块及混合性斑块的检出情况与DSA比较差异无统计学意义(P>0.05)；在两种检查方法中斑块检出率最高的为硬斑块；64排螺旋CT诊断狭窄冠脉的特异性为92.36%、敏感性为94.18%、准确性为92.67%、阴性预测值为94.73%、阳性预测值为91.89%。 结论 64排螺旋CT冠状动脉成像能比较准确地对隐匿型冠心病狭窄冠状动脉情况及斑块性质做出判断，这对临床上防治隐匿型冠心病具有极为重要的价值。
[关键词] 隐匿型冠心病；64排螺旋CT；冠状动脉；斑块性质
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2015)11(c)-0174-03
[Abstract] Objective To explore the diagnostic value of 64 row spiral CT in the diagnosis of occult coronary heart disease and plaque. Methods Cases were derived from 140 patients with concealed coronary heart disease who had imaging examinations of coronary artery by 64 row spiral CT and were treated in the hospital from February 2012 to August 2014， the detection of coronary artery and plaque in patients with coronary artery stenosis by 64 row spiral CT was compared according to the results of DSA test. Compared with the control group， the detected cases of 64 row spiral CT for coronary artery stenosis in patients with occult coronary artery disease and single vessel and multiple coronary artery stenosis had no obvious difference and the difference was not statistically significant(P>0.05). Results There were independent mild stenosis and single coronary artery stenosis patients in occult coronary lesions； the difference of the detection of 64 row spiral CT on plaque， occult coronary heart disease vascular hard and soft plaque and mixed plaque compared with DSA had no statistical significance (P>0.05)； the plaque detection rate was the highest of the two examination methods； the specificity of the 64 row spiral CT in the diagnosis of coronary stenosis was 92.36%， the sensitivity was 94.18%， the accuracy was 92.67%， the negative predictive value was 94.73% and the positive predictive value was 91.89%. Conclusion 64 row spiral CT coronary artery imaging can accurately determine the coronary artery stenosis and plaque characteristics of concealed coronary artery disease， which is of vital value for clinical prevention and treatment of occult coronary artery disease.
[Key words] Virus infection aslar-pacific perspective of coronary heart disease； 64 row spiral CT； Coronary artery； Nature of the plaque
在冠心病发生发展及转归的过程中，冠状动脉的斑块性质在其中的意义比斑块造成的管腔狭窄的程度更大，准确地评估冠脉斑块性质对冠心病的危险程度分级以及临床治疗具有重要的指导意义[1]。随着现代医学的发展，64排螺旋CT逐渐取代以往多研究冠脉狭窄程度的多层螺旋CT，又因64排螺旋CT在时间和空间分辨率上表现出来的优势以及快速的扫描速度而被人们寄予很高的期望[2-3]。该研究整群选取2012年2月—2014年8月来该院治疗的经DSA与64排螺旋CT做冠状动脉成像检查的140例隐匿型冠心病患者作为研究对象，运用64排螺旋CT进行无创冠状动脉成像检查来判断冠脉斑块性质，在防治发生冠状动脉急性突发事件具有很重要的临床价值，现报道如下。 (张学昌 李晓倩 王振光)
[关键词] 隐匿型冠心病；64排螺旋CT；冠状动脉；斑块性质
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2015)11(c)-0174-03
[Abstract] Objective To explore the diagnostic value of 64 row spiral CT in the diagnosis of occult coronary heart disease and plaque. Methods Cases were derived from 140 patients with concealed coronary heart disease who had imaging examinations of coronary artery by 64 row spiral CT and were treated in the hospital from February 2012 to August 2014， the detection of coronary artery and plaque in patients with coronary artery stenosis by 64 row spiral CT was compared according to the results of DSA test. Compared with the control group， the detected cases of 64 row spiral CT for coronary artery stenosis in patients with occult coronary artery disease and single vessel and multiple coronary artery stenosis had no obvious difference and the difference was not statistically significant(P>0.05). Results There were independent mild stenosis and single coronary artery stenosis patients in occult coronary lesions； the difference of the detection of 64 row spiral CT on plaque， occult coronary heart disease vascular hard and soft plaque and mixed plaque compared with DSA had no statistical significance (P>0.05)； the plaque detection rate was the highest of the two examination methods； the specificity of the 64 row spiral CT in the diagnosis of coronary stenosis was 92.36%， the sensitivity was 94.18%， the accuracy was 92.67%， the negative predictive value was 94.73% and the positive predictive value was 91.89%. Conclusion 64 row spiral CT coronary artery imaging can accurately determine the coronary artery stenosis and plaque characteristics of concealed coronary artery disease， which is of vital value for clinical prevention and treatment of occult coronary artery disease.
[Key words] Virus infection aslar-pacific perspective of coronary heart disease； 64 row spiral CT； Coronary artery； Nature of the plaque
在冠心病发生发展及转归的过程中，冠状动脉的斑块性质在其中的意义比斑块造成的管腔狭窄的程度更大，准确地评估冠脉斑块性质对冠心病的危险程度分级以及临床治疗具有重要的指导意义[1]。随着现代医学的发展，64排螺旋CT逐渐取代以往多研究冠脉狭窄程度的多层螺旋CT，又因64排螺旋CT在时间和空间分辨率上表现出来的优势以及快速的扫描速度而被人们寄予很高的期望[2-3]。该研究整群选取2012年2月—2014年8月来该院治疗的经DSA与64排螺旋CT做冠状动脉成像检查的140例隐匿型冠心病患者作为研究对象，运用64排螺旋CT进行无创冠状动脉成像检查来判断冠脉斑块性质，在防治发生冠状动脉急性突发事件具有很重要的临床价值，现报道如下。 (张学昌 李晓倩 王振光)