目的 探讨双源CT冠状动脉造影 (DSCTA)对冠心病患者冠状动脉狭窄的诊 断价值。方法 选取2017年9月-2018年9 月间收治的拟诊为冠心病的患者120例作 为研究对象，所有患者均予以DSCTA、冠 状动脉造影(CAG)和冠状动脉血管内超声 (IVUS)检查。以CAG为金标准，评估DSCTA 诊断冠脉狭窄的效能、狭窄程度准确率； 以IVUS检查为金标准，评估DSCTA诊断斑 块性质的效能。结果 ①DSCTA诊断冠脉狭 窄的灵敏度为93.75%、特异度97.78%、准 确率96.67、阳性预测值94.17%、阴性预 测值97.62%；②DSCTA准确诊断无狭窄冠 脉节段1147段、准确率97.62%，DSCTA准 确诊断轻度冠脉狭窄节段124段、准确率 84.93%(124/146)，准确诊断中度冠脉狭 窄节段106段、准确率84.80%(106/125)， 准确诊断重度冠脉狭窄节段163段、准确 率93.14%(163/175)；③ IVUS共检测出 394个粥样硬化斑块，DSCTA准确诊断软 斑块105个、准确率82.68%(105/127)， DSCTA准确诊断纤维型斑块126个、准确 率89.36%(126/141)，DSCTA准确诊断钙 化斑块31个、准确率81.58%(31/38)， DSCTA准确诊断混合斑块74个、准确率 84.09%(74/88)。结论 DSCTA安全无创， 在冠心病的诊断、狭窄程度评估、粥样硬 化斑块的定性方面均具有较高的诊断效 能。

Objective To evaluate the diagnostic value of dual-source computed tomography coronary angiography (DSCTA) in coronary artery stenosis of patients with coronary heart disease. Methods A total of 120 patients with coronary heart disease who admitted between September 2017 and September 2018 were selected for the study. All patients were given DSCTA, coronary angiography (CAG) and coronary intravascular ultrasound (IVUS). CAG was used as the gold standard to evaluate the efficacy and accuracy rate of stenosis of DSCTA in the diagnosis of coronary stenosis. IVUS examination was taken as the gold standard to evaluate the efficacy of DSCTA in diagnosing plaque properties. Results The sensitivity, specificity, accuracy rate, positive predictive value and negative predictive value of DSCTA in the diagnosis of coronary stenosis were 93.75%, 97.78%, 96.67, 94.17% and 97.62%. 1147 segments without coronary stenosis were accurately diagnosed by DSCTA and the accuracy rate was 97.62%, and 124 segments with mild coronary stenosis were diagnosed by DSCTA accurately and the accuracy rate was 84.93% (124/146), and 106 segments with moderate coronary stenosis were diagnosed and the accurate rate was 84.80% (106/125), and 163 segments with severe coronary stenosis were diagnosed and the accurate rate was 93.14% (163/175). A total of 394 atherosclerotic plaques were detected by IVUS, and 105 soft plaques were diagnosed DSCTA accurately and the accuracy rate was 82.68% (105/127), and 126 fibrous plaques were accurately diagnosed DSCTA and the accuracy rate was 89.36% (126/141), and 31 calcified plaques were diagnosed accurately by DSCTA and the accuracy rate was 81.58% (31/38), and 74 mixed plaques were diagnosed by DSCTA and the accuracy rate was 84.09% (74/88). Conclusion DSCTA is safe and non-invasive, and has high efficacy in diagnosing coronary stenosis, the degree of stenosis, and the diagnosis of atherosclerotic plaque in patients with coronary heart disease.