标题：256层螺旋CTA在冠状动脉狭窄及斑块诊断中的应用价值

      作者：魏全杰，关晓涛，张丹丹，李瑞峰，田素贞，何首勋    襄城县人民医院CT室，河南 襄城 461700

      卷次： 2019年30卷21期

      【摘要】 目的 探讨 256层螺旋 CT动脉血管造影(CTA)对冠状动脉狭窄及不同性质斑块的诊断价值。方法 2014年 3月至 2019年4月期间襄城县人民医院CT室对68例冠心病患者行256层螺旋CTA检查及冠状动脉造影(CAG)，以CAG结果为参考标准，评估256层CTA对不同性质斑块所致冠状动脉狭窄的敏感度、特异度、阳性预测值、阴性预测值及诊断符合率，并分析冠状动脉斑块的性质。结果 68例患者中，256层CTA诊断符合率为95.6% (65/68)。CTA对冠状动脉轻度狭窄的敏感性、特异性、阳性预测值、阴性预测值分别为 100.0%、96.6%、97.5%、100.0%；CTA对冠状动脉中度狭窄的敏感性、特异性、阳性预测值、阴性预测值分别为88.2%、98.0%、93.8%、96.2%；CTA对冠状动脉重度狭窄的敏感性、特异性、阳性预测值、阴性预测值分别为91.7%、98.2%、91.7%、98.2%。CTA诊断 68例冠状动脉斑块，其中软斑块 11例(16.2%)、纤维斑块 11例(16.2%)、混合斑块 21例(30.9%)、钙化斑块25例(36.8%)。结论 CTA能够有效判断冠状动脉狭窄程度及斑块成分，对冠状动脉狭窄程度及斑块有很大诊断价值，可作为医院首选检查方法。
      【关键词】 冠状动脉狭窄；冠状动脉粥样硬化斑块；256层CT冠状动脉造影；冠状动脉造影；诊断价值
      【中图分类号】 R543.3 【文献标识码】 A 【文章编号】 1003—6350（2019）21—2795—04

Value of 256-slice spiral CTA in the diagnosis of coronary artery stenosis and plaque.
WEI Quan-jie, GUANXiao-tao, ZHANG Dan-dan, LI Rui-feng, TIAN Su-zhen, HE Shou-xun. CT Room, Xiangcheng County People's Hospital,Xiangcheng 461700, Henan, CHINA
【Abstract】 Objective To evaluate the diagnostic value of 256-slice spiral CT angiography (CTA) for coronaryartery stenosis and plaques with different properties. Methods Between March 2014 and April 2019, 68 patients withcoronary artery disease were examined by 256-slice spiral CTA and coronary angiography in the CT room ofXiangcheng County People's Hospital. Using CAG results as a reference standard, the sensitivity, specificity, positivepredictive value, negative predictive value, and diagnostic coincidence rate were evaluated for 256-slice CTA in coro-nary artery stenosis caused by plaques with different properties, and the properties of coronary artery plaques were ana-lyzed. Results Among the 68 patients, the diagnostic coincidence rate of 256-slice CTA was 95.6% (65/68). The sensi-tivity, specificity, positive predictive value, and negative predictive value of CTA were 100.0%, 96.6%, 97.5%, 100.0%for mild stenosis of coronary artery; 88.2% , 98.0% , 93.8% , 96.2% for moderate stenosis of coronary artery; 91.7% ,98.2%, 91.7%, 98.2% for severe stenosis of coronary artery. A total of 68 coronary artery plaques were diagnosed byCTA, including soft plaques in 11 cases (16.2% ), fibrous plaques in 11 cases (16.2% ), mixed plaques in 21 cases