256螺旋CT冠脉成像与DSA血管造影的对比研究

目的:对比256层螺旋计算机断层扫描(MSCT)与数字减影血管造影(DSA)在临床冠脉疾病诊断中的应用。方法:回顾性分析80例疑似冠脉疾病并在1周内分别采用256层MSCT、DSA诊断者的临床资料。对比二者对不同冠脉分段狭窄程度的评估结果;将DSA结果记为“金标准”,分析256层MSCT诊断冠脉狭窄的效能;统计256层MSCT对不同冠脉分段斑块形成的诊断结果。结果:冠脉血管节段可评价率为96.14%;256层MSCT、DSA对不同冠脉分段及总狭窄程度分布、狭窄检出率对比差异均无统计学意义(P>0.05);256层MSCT诊断冠脉狭窄的灵敏度、特异度、准确度、约登指数分别为97.92%、99.45%、98.57%、0.974;256层MSCT检出的568个冠脉狭窄段中共检出1036个斑块,其中钙化斑块、非钙化斑块、混合斑块分别有429个、200个、407个,占比分别为41.41%、19.31%、39.29%。结论:256层MSCT可诊断冠脉疾病,其诊断价值与DSA相当,且还可检出冠脉斑块形成情况及斑块性质。

Comparative study of 256 slice spiral CT coronary angiography and DSA angiography in clinical application

Objective To compare the application between 256 slice spiral computed tomography(MSCT)and digital subtraction angiography(DSA)in the diagnosis of coronary artery disease.Methods The clinical data of 103 patients with suspected coronary artery disease were retrospectively analyzed,who were diagnosed by 256 slice MSCT and DSA within one week.The evaluation results of the two methods were compared.The results of DSA were recorded as"gold standard"to analyze the efficacy of 256 slice MSCT in the diagnosis of coronary artery stenosis.The diagnostic results of 256 slice MSCT in different coronary segments were statistically analyzed.Results The evaluable rate of coronary artery segments was 96.14%.There was no significant difference between 256 slice MSCT and DSA in the distribution of different degrees and stenosis detection rates of coronary segments and total stenosis(P>0.05).The sensitivity,specificity,accuracy and Youden index of 256 slice MSCT were 97.92%,99.45%,98.57% and 0.974,respectively.A total of 1036 plaques were detected in 568 coronary stenosis segments detected by 256 slice MSCT,including 429 calcified plaques,200 non calcified plaques and 407 mixed plaques,accounted for 41.41%,19.31% and 39.29% respectively.Conclusion 256 slice MSCT can diagnose coronary artery disease,of which the diagnostic value is equivalent to DSA,and it can also detect the formation and nature of coronary plaques.