摘要
目的研究多层螺旋CT冠脉钙化积分在冠心病诊断中的价值。方法 42例(24例临床诊断心绞痛,6例有陈旧性心梗史,其余12例无症状)行多层螺旋CT(MSCT)钙化积分检查,所有病例另行冠状动脉造影检查。结果 冠心病组的平均冠脉钙化总积分(TCS)为363±647,与无症状组的55.86±54有显著性差异(P<0.05);TCS=0的范围内均为造影正常血管组,在1～400和TCS>400范围内有血管造影正常组和病变组;以冠脉造影作为金标准,MSCT检测冠脉钙化的敏感性:100％,特异性:25％,准确性:78.6％,阳性预测值:76.9％,阴性预测值:100％。冠脉狭窄面积(φ)<50％组的狭窄血管平均钙化分数为67.4±127.7,与狭窄面积>75％组的62±155无显著性差异(p>0.05)。结论 1.MSCT对于冠脉钙化的检出有较为突出的价值,其敏感性和准确性均较高,因此适合作为冠心病普查手段。2.钙化仅仅是动脉粥样硬化斑块负荷的一个标志,而不是管腔严重狭窄的标志,故不能用来预测血管狭窄程度。
Objective To study the significance of coronary artery calcium by muliti - slice spiral CT (MSCT) in diagnosing coronary heart disease. Methods ECG gated MSCT was performed in 42 patients, Which were 24 with history of angina pectoris, 6 with history of myocar-dial infarction and 12 asymptomatic. Diagnosis was proved by coronary angiography. Results Significant difference(p<0.05) in the total coronary artery calcification score(TCS) existed between coronary heart disease group(363±647) and asymptomatic group(55.86±54) . The Range of TCS = 0 were normal on coronary angiography. The range of TCS both in 1-400 group and in more than 400 group were normal or abnormal on coronary angiography. Using coronary arteriographic findings as a gold standard, the sensitivity of MSCT for detection of the calcification was 100% , the specificity was 25% , the accuracy was 78.6% , the positive predictive value was 76.9% , and the negative predictive value was 100% . There was no significant difference in coronary calcium score (CCS) between the segments with lumen narrowing < 50% and those with lumen narrowing > 75% (67.4±127.7 vs 62±155, p > 0.05 ) . Conclusions 1. There is prominent value in detecting coronary artery calcification by MSCT, both sensitivity and accuracy are high. It can be used as a mean of screening coronary heart diseases. 2. Coronary artery calcium is only a marker of atherosclerosis instead of the marker of lumen narrowing. Therefore, CCS can not accurately predict the severity of lumen narrowing.
出处
《上海医学影像》
2003年第1期41-43,共3页
Shanghai Medical Imaging
