影像科学与光化学 ›› 2020, Vol. 38 ›› Issue (3): 491-495.DOI: 10.7517/issn.1674-0475.191115

• 综述与论文 • 上一篇    下一篇

多层螺旋CT血管造影对冠状动脉粥样硬化性心脏病患者冠脉狭窄程度及斑块稳定性的评价

徐伟华   

  1. 廊坊市人民医院 放射诊断科, 河北 廊坊 065000
  • 收稿日期:2019-11-18 出版日期:2020-05-15 发布日期:2020-05-15

Evaluation of Coronary Stenosis and Plaque Stability by Multi-slice Spiral CT Angiography in Patients with Coronary Atherosclerotic Heart Disease

XU Weihua   

  1. Department of Radiology, Langfang People's Hospital, Langfang 065000, Hebei, P. R. China
  • Received:2019-11-18 Online:2020-05-15 Published:2020-05-15

摘要: 为探讨多层螺旋CT血管造影(MSCTA)对冠脉狭窄病变的检出效能,以及对冠脉狭窄程度和斑块稳定性的评价,本研究选取2018年7月~2019年8月我院收治的冠心病患者80例,所有患者均行动脉造影(CAG)和MSCTA检查。以CAG检查结果作为对照,观察MSCTA对冠脉狭窄病变和冠脉斑块的检出效能。结果显示,MSCTA检出冠脉狭窄病变的灵敏度、特异度、符合率与CAG检出结果的一致性良好(kappa=0.871,P=0.000)。MSCTA对冠脉轻微狭窄、轻度狭窄、中度狭窄、重度狭窄的检出率与CAG比较,差异均无统计学意义(P>0.05)。稳定型心绞痛患者冠脉斑块以钙化斑块为主,不稳定型心绞痛患者冠脉斑块以软斑块为主。MSCTA对稳定型心绞痛和不稳定型心绞痛患者冠脉斑块性质的检出率比较,差异有统计学意义(P<0.05)。因此,MSCTA对冠脉狭窄病变具有较高的诊断效能,可有效评价冠心病患者冠脉狭窄程度及斑块稳定性,为冠心病患者临床治疗及预后评估提供可靠的影像学依据。

关键词: 冠心病, 多层螺旋CT血管造影, 冠脉狭窄程度, 斑块稳定性

Abstract: To investigate the detection efficiency of multi-slice spiral CT angiography (MSCTA) on coronary stenosis and plaque stability, 80 patients with coronary heart disease in our hospital from July 2018 to August 2019 were selected in this study. All patients were examined by angiography (CAG) and MSCTA. The results of CAG were used as control, the detection efficiency of coronary stenosis and plaques by MSCTA was calculated. The results show that the sensitivity, specificity and coincidence rate of MSCTA in detecting coronary stenosis were in good agreement with CAG (kappa=0.871, P=0.000). There was no significant difference in the detection rate of coronary artery stenosis, mild stenosis, moderate stenosis and severe stenosis between MSCTA and CAG (P>0.05). The main coronary plaques in patients with stable angina are calcified plaques, and the main coronary plaques in patients with unstable angina are soft plaques. MSCTA has a statistically significant difference in the detection rate of coronary plaque between patients with stable angina and unstable angina (P<0.05). Therefore, MSCTA has a high diagnostic efficiency for coronary stenosis. It can effectively evaluate the degree of coronary stenosis and plaque stability in patients with coronary heart disease, as well as provide reliable imaging basis for clinical treatment and prognosis evaluation.

Key words: coronary heart disease, multi-slice spiral CT angiography (MSCTA), degree of coronary stenosis, plaque stability