论著-头颈部
多层螺旋CT与超声心动图在诊断冠心病中的应用比较
作者:殷保江1 贾晓辉2 杨星奎3
所属单位:1.河南省舞钢市人民医院超声科(河南 舞钢 462500) 2.河南省舞钢市人民医院CT室(河南 舞钢 462500) 3.河南省舞钢市人民医院外科(河南 舞钢 462500)
PDF摘要
目的对比分析64排螺旋CT冠脉 造影(CTA)与超声心动图(UCG)在冠心病诊 断中的价值。方法 回顾性收集2016年6 月-2017年12月我院收治的46例疑诊冠状 动脉狭窄患者,均行CTA、UCG检查,并与 冠状动脉造影(CAG)检查结果进行对照。 结果 46例患者,CAG检出37例阳性,9例 阴性;以CAG诊断结果为“金标准”,CTA 诊断CHD的准确度、敏感度、特异度、阳 性预测值、阴性预测值分别为73.91%、 75.68%、88.89%、93.33%、42.11%,均 高于UCG的58.70%、56.77%、66.67%、 87.50%、27.27%,但差异无统计学意义 (P>0.05);两者联合检查诊断冠心病的准 确度、敏感度分别为91.30%、91.89%,均 明显高于单纯CTA或UCG检查,差异有统计 学意义(P<0.05)。结论 CTA、UCUG对冠心 病诊断均有较高价值,两者联合应用,可 提高诊断准确度。
Objective To compare and analyze the value of 64 - slice spiral CT coronary angiography (CTA) and ultrasound cardiography(UCG) in the diagnosis of coronary heart disease (CHD). Methods 46 patients with suspected CHD who were admitted to the hospital from June 2016 to December 2017 were retrospectively collected. All of them underwent CTA and UCG, and the results were compared with those of coronary angiography (CAG). Results In the 46 cases, 37 cases were positiveand 9 cases were negative detected by CAG. With diagnostic results of CAG as the golden standard, the diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of CTA for CHD were 73.91%, 75.68%, 88.89%, 93.33% and 42.11%, respectively which were higher than those of UCG (58.70%, 56.77%, 66.67%, 87.50%, 27.27%) (P>0.05). The accuracy and sensitivity of the combined examination in diagnosing CHD were 91.30% and 91.89%, respectivelywhich were significantly higher than those of simple CTA or UCG(P<0.05). Conclusion CTA and UCUG are of great value in the diagnosis of CHD. The combined use of the two can improve the diagnostic accuracy.
【关键词】冠心病;多层螺旋CT;超声心动图;诊断
【中图分类号】R541.4
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2018.08.021
前言
冠心病(coronary heart disease,CHD)是常见的心血管疾病之 一,是导致我国成年心脏病死亡的主要原因,其发病率逐年增高,且 呈年轻化趋势,及早明确诊断、积极治疗对改善患者预后有重要意 义[1]。目前,冠状动脉造影(coronary angigraphy,CAG)仍为CHD诊断 的“金标准”,但其具有创伤性,重复性差,且检查费用高,因此寻 找一种无创、有效、经济的检查方法成为临床研究热点。多层螺旋 CT(multi-slice spiral computed tomography,MSCT)具有无创、分 辨率高、扫描迅速等优势,在CHD诊断中应用日趋成熟[2]。超声心动图 (ultrasound cardiography,UCG)能够评价心脏结构、血流及功能等变 化,亦是诊断CHD的重要方法之一[3]。然而,关于MSCT与UCG对于CHD诊 断价值报道不一,目前仍缺乏足够数据支持。因此,本研究回顾性分 析46例行冠状动脉CT成像(computed tomography angiography,CTA)、 UCG及CAG检查的患者临床资料,旨在探讨CTA、UCG对CHD的诊断价值, 现报告如下。
中国CT和MRI杂志
第16卷, 第 8 期
2018年08月
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