双源CT冠状动脉成像对糖尿病患者合并冠状动脉狭窄的应用研究
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Dual-source CT coronary angiography in patients with diabetes accompanied with coronary artery stenosis
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    摘要:

    目的:通过与传统冠状动脉造影(CAG)对比,探讨双源CT冠状动脉成像(DSCTA)对糖尿病患者合并冠状动脉狭窄的诊断价值-方法:对81例2型糖尿病可疑合并冠心病患者行DSCTA检查,扫描图像经工作站进行多种方法重建,评估管径≥2.0 mm的近端12个节段,筛选出血管狭窄程度≥50%的患者,并采用四格表χ2检验,以CAG为对照分析-结果:81例患者有68例显示血管狭窄程度≥50%,其中42例(61.8%)有多支血管狭窄,68例均行CAG检查-68例共有793支冠状动脉节段显示清晰可评价,可评价率为97.2%-以CAG检查为金标准,DSCTA检测血管狭窄程度≥50%的敏感度-特异度-阳性预测值-阴性预测值分别为95.6%-97.7%-89.7%-99.1%;两种检查方法之间的差异无统计学意义(P > 0.05)-DSCTA检测心率< 70次/min及≥70次/min的糖尿病患者冠状动脉狭窄的敏感性(97.4% vs 93.2%)-特异性(97.6% vs 97.9%)-阳性预测值(89.4% vs 90.2%)-阴性预测值(99.5% vs 98.6%)差异无统计学意义(P > 0.05)-结论:DSCTA具有图像清晰-扫描速度快及无创等优点,且不受心率的影响,是有效的冠状动脉检查方法,可作为2型糖尿病患者怀疑合并冠心病的筛查-

    Abstract:

    Objective:By comparing with conventional coronary angiography(CAG),we sought to investigate the diagnostic value of dual-source CT coronary angiography(DSCTA)to diabetic patients with coronary artery stenosis. Methods:A DSCTA inspection was established to 81 cases of type 2 diabetes in patients with suspected coronary heart disease,along with a variety of scanned images reconstructed by the Workstation. We then assessed 12 segments of the proximal diameter ≥2.0 mm,selected patients of stenosis degree ≥50%,and adopted 2x2 contingency table with chi-square test. Results:A total of 68 cases showed stenosis ≥50% in all 81 patients,and 42 out of these 68 patients(61.8%)had multiple-vessel stenosis,and CAG examination was performed in all these 68 patients. Sixty-eight patients along with a total of 793 coronary artery segments were clear and evaluable,with the evaluable rate of 97.2%. CAG was set as the gold standard,and the predicted values of sensitivity,specificity,positive predictive value,negative with DSCTA detected vascular stenosis ≥50% were 95.6%,97.7%,89.7% and 99.1%,respectively. The difference between the two methods was not statistically significant(P > 0.05). The sensitivity(97.4% vs 93.2%),specificity(97.6% vs 97.9%),positive predictive value(89.4% vs 90.2%),and negative predictive value(99.5% vs 98.6%) of DSCTA detected coronary artery stenosis between rate < 70 beats/min and ≥70 beats/min in diabetic patients was not significantly different(P > 0.05). Conclusion:DSCTA has clear image,rapid scanning speed and is non-invasive,etc,which is not influenced by the heart rate. It is an effective coronary artery screening method,especially for type 2 diabetic patients with coronary heart disease.

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周 明,钱 斌,陈宏伟,万红燕,朱宗明,翟晓东.双源CT冠状动脉成像对糖尿病患者合并冠状动脉狭窄的应用研究[J].南京医科大学学报(自然科学版),2014,(8):1131-1135

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  • 收稿日期:2014-01-16
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  • 在线发布日期: 2014-08-03
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