CT血管成像与数字减影血管造影评估冠心病冠状动脉狭窄程度的临床价值
Clinical value of CTA and DSA in evaluating the degree of coronary artery stenosis in coronary heart disease
刘志方 1畅龙 1费建1
作者信息
- 1. 512026 广东省韶关市中医院放射科
- 折叠
摘要
目的 探究冠心病患者接受CT血管成像(CTA)与数字减影血管造影(DSA)诊断的价值.方法 选取2022年1月至2022年12月期间,我院总院区及韶钢院区接收的疑似冠心病患者,共计70例作为研究对象,所有患者入院后首先给予CTA检查,于7 d后开展DSA检查,并以DSA诊断结果为金标准,来评价CTA对冠心病冠状动脉狭窄程度的临床价值.结果 70例疑似冠心病患者经DSA确诊患者有61例,经CTA检出冠状动脉阳性病变60例;CTA对冠状动脉阳性病变的诊断阳性预测值为98.3％,阴性预测值为80.0％,准确度为95.7％,灵敏度为96.7％,特异度为88.9％;CTA检查轻度狭窄、中度狭窄、重度狭窄及闭塞检出率分别为51.3％、29.3％、19.3％,0％,DSA检查轻度狭窄、中度狭窄、重度狭窄及闭塞检出率分别为52.5％、31.2％、16.2％,0％,2种检查方法对冠心病冠状动脉狭窄程度检查率差异无统计学意义(P＞0.05);CTA对无狭窄/轻度狭窄冠状动脉狭窄中钙化斑块、混合斑块、非钙化斑块检出率分别为63.6％、19.5％、16.9％,对中度/重度狭窄冠状动脉狭窄中钙化斑块、混合斑块、非钙化斑块检出率分别为12.3％、45.2％、42.5％,CTA对无狭窄/轻度狭窄冠状动脉狭窄中钙化斑块检出率高于中度/重度狭窄,混合斑块、非钙化斑块检出低于中度/重度狭窄,差异均具有统计学意义(P＜0.05).结论 CTA与DSA在冠心病患者诊断工作中均具有显著价值,且2种诊断方案在评估患者冠状动脉狭窄程度方面的一致度较高.
Abstract
Objective To explore the diagnostic value of CT angiography(CTA)and digital subtraction angiogra-phy(DSA)in patients with coronary heart disease.Methods A total of 70 suspected coronary heart disease patients admitted to our main hospital and Shaogang Hospital from January 2022 to December 2022 were selected as the re-search subjects of this study.All patients were first given a CTA examination after admission,and a DSA examination was conducted 7 days later.The clinical value of CTA in assessing the degree of coronary artery stenosis in coronary heart disease was evaluated using DSA diagnostic results as the gold standard.Results Among the 70 suspected coro-nary heart disease patients,61 cases(87.1％)were confirmed by DSA,and 60 cases(85.7％)were detected as positive coronary artery lesions by CTA.The positive predictive value of CTA for positive coronary artery lesions was 98.3％,the negative predictive value was 80.0％,the accuracy was 95.7％,the sensitivity was 96.7％,and the specificity was 88.9％.The detection rates of mild stenosis,moderate stenosis,severe stenosis,and occlusion in CTA examination were 51.3％,29.3％,19.3％,and 0％,respectively.The detection rates of mild stenosis,moderate stenosis,severe stenosis,and occlusion in DSA examination were 52.5％,31.2％,16.2％,and 0％,respectively.There was no statistically signifi-cant difference in the degree of coronary artery stenosis in coronary heart disease between the two examination methods(P＞0.05).The detection rates of calcified plaques,mixed plaques,and non-calcified plaques in non-stenosis/mild steno-sis coronary artery stenosis by CTA were 63.6％,19.5％,and 16.9％,respectively.The detection rates of calcified plaques,mixed plaques,and non-calcified plaques in moderate/severe stenosis coronary artery stenosis were 12.3％,45.2％,and 42.5％,respectively.The detection rates of calcified plaques in non-stenosis/mild stenosis coronary artery stenosis by CTA were higher than those in moderate/severe stenosis,while the detection rates of mixed plaques and non-calcified plaques were lower than those in moderate/severe stenosis,and the differences were statistically significant(P＜0.05).Conclusion CTA and DSA have significant value in the diagnosis of coronary heart disease patients,and the consistency between the two diagnostic schemes in evaluating the degree of coronary artery stenosis in patients is high.
关键词
血管造影术,数字减影/冠心病/CT血管成像/冠状动脉狭窄Key words
Angiography,digital subtraction/Coronary disease/CT angiography/Coronary stenosis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据