冠状动脉CT血管造影对急性冠状动脉综合征的评价及影响因素分析
Evaluation and influencing factors of coronary CT angiography in acute coronary syndrome
王安吉 1徐春雪 2薛永利1
作者信息
- 1. 首都医科大学附属北京朝阳医院心脏中心导管室(北京,100020)
- 2. 北京中医药大学东直门医院核医学科
- 折叠
摘要
目的:分析冠状动脉CT血管造影(CTA)对急性冠状动脉综合征(ACS)的诊断价值,探究影响CTA图像质量的因素.方法:选取2020年8月-2022年9月于我院就诊的156例疑似ACS患者为研究对象,所有患者均行CTA检查,以冠状动脉造影(CAG)为金标准,分析CTA在ACS中的应用价值.将患者分为图像优良组(116例)、图像不佳组(40例),采用logistic回归分析其影响因素.结果:156例疑似ACS患者,CAG诊断为ACS阳性106例、阴性50例,CTA诊断为ACS为104例、其他52例,CTA诊断ACS灵敏度为88.68％(94/106)、特异度为80.00％(40/50)、准确度为85.90％(134/156).两种诊断方式在冠状动脉狭窄程度、斑块性质方面比较无显著差异.与图像优良组比较,图像不佳组屏气不理想、钙化、心律不齐占比更多(P＜0.05).Logistic回归分析显示屏气不理想、钙化是CTA图像质量的影响因素(P＜0.05).结论:CTA在ACS诊断中有一定临床参考价值,屏气不理想、钙化是影响图像质量的因素.
Abstract
Objective:To analyze the diagnostic value of coronary CT angiography(CTA)in acute coronary syndrome(ACS)and explore the factors affecting the image quality of CTA.Methods:A total of 156 patients with suspected ACS who were treated in our hospital from August 2020 to September 2022 were selected.All patients underwent CTA examination,and coronary angiography(CAG)both.The patients were divided into good image group(116 cases)and poor image group(40 cases),and the influencing factors were analyzed by logistic regres-sion.Results:Among 156 suspected ACS patients,CAG was diagnosed as positive in 106 cases,negative in 50 ca-ses,and CTA was diagnosed as ACS in 104 cases and other 52 cases.The sensitivity of CTA in diagnosing ACS was 88.68％(94/106),specificity was 80.00％(40/50),and accuracy was 85.90％(134/156).There was no sig-nificant difference between the two diagnostic methods in the degree of coronary artery stenosis and the nature of plaque.Compared with the good image group,there were more unsatisfactory breath holding,calcification and ar-rhythmia in the poor image group(P＜0.05).Logistic regression analysis showed that unsatisfactory breath hold-ing and calcification were the influencing factors of CTA image quality(P＜0.05).Conclusion:CTA has a certain clinical reference value in the diagnosis of ACS.The factors that affect the image quality are unsatisfactory breath holding and calcification.
关键词
急性冠状动脉综合征/CT血管造影/冠状动脉造影/图像质量/影响因素Key words
acute coronary syndrome/CT angiography/coronary angiography/image quality/influencing factor引用本文复制引用
出版年
2024
NETL
NSTL
万方数据