目 的 分析64层双源螺旋 CT(DSCT)与冠脉造影(CAG)在冠脉易损 斑块中的诊断价值。方法 选取2013年7 月-2015年7月因典型症状于我院就诊的63 例冠心病患者作为研究对象，分别作64层 双源螺旋CT检查与冠脉造影检查，评估64 层双源螺旋CT在冠脉易损斑块中的诊断价 值。结果 DSCT检出冠脉狭窄病变141处， CAG检出156处，两者检出冠脉病变节段数 对比差异无统计学意义(P>0.05)，以CAG 作为标准，DSCT检测敏感度为93.6%，特 异性为94.3%，阴性预测值为97.0%，阳 性预测值为84.6%；DSCT检出稳定性心绞 痛患者软斑块、纤维斑块、硬斑块分别 占16.7%、26.7%、56.7%，其中软斑块所 占比例显著低于不稳定型心绞痛组，硬 斑块比例则显著高于不稳定型心绞痛组 (P<0.05)；DSCT共检出156处冠脉斑块病 变，与CAG检出率无差异，其中轻度、中 度、重度狭窄分别为21处、66处与57处， 轻度、中度狭窄均以软斑块为主，重度狭 窄以硬斑块为主，重度组硬斑块所占比例 显著高于轻中度狭窄组(P<0.05)。结论 DSCT对冠心病患者冠脉狭窄程度、斑块性 质的诊断均有较高的准确性，与CAG有较 高的符合度，对指导冠心病相关心血管并 发症的防治有积极的价值。

Objective To analyze the diagnostic value of 64 slice dual-source spiral CT (DSCT) and coronary angiography (CAG) in coronary vunerable plaques. Methods 63 patients with coronary heart disease treated in our hospital for typical symptoms from July 2013 to July 2015 were selected as the research objects. 64 slice dual-source spiral CT and coronary angiography were performed respectively. The value of 64 slice dual-source spiral CT in the diagnosis of coronary vulnerable plaques was evaluated. Results DSCT detected 141 lesions of coronary stenosis while CAG detected 156 (P>0.05). Taking CAG as the standard, the sensitivity of DSCT was 93.6%, specificity was 94.3%, the negative predictive value was 97.0% and the positive predictive value was 84.6%; Soft plaques, fibrous plaques and hard plaques in patients with stable angina pectoris detected by DSCT accounted for 16.7%, 26.7% and 56.7%, respectively. The proportion of soft plaques was significantly lower than that in the unstable angina pectoris group while the proportion of hard plaques was significantly higher (P<0.05); There were 156 lesions of coronary plaques detected by DSCT, which was not different from the detection rate of CAG, including 21 mild, 66 moderate and 57 severe stenosis. Mild and moderate stenosis were mainly with soft plaqies while severe stenosis was with hard plaques. The proportion of hard plaques in the severe group was significantly higher than those in mild and moderate stenosis group (P<0.05). Conclusion DSCT has high accuracy in the diagnosis of severity of coronary stenosis and the nature of plaques in patients with coronary heart disease. It has high conformity with CAG and has positive value for guiding the prevention and treatment of coronary heart disease related cardiovascular complications