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目的评价双层螺旋CT血管造影(DHCTA)与冠状动脉钙化(CAC)积分诊断冠心病(CHD)的临床价值。方法对52例疑有CHD的患者行冠状动脉造影(CAG)、双层螺旋CT扫描检测CAC积分,并行DHCTA扫描,源像输入HP4.1工作站后作多模式三维重建。以CAG结果为金标准来分析DHCTA和CAC积分对CHD的诊断效能。结果DHCTA和CAC积分诊断CHD的灵敏度、特异性、准确性分别为70%、90.9%、78.8%和93.3%、63.6%、80.8%。二者比较DHCTA的灵敏度低于CAC积分,而特异性明显高于CAC积分,准确性比较差异无统计学意义(P>0.05)。将二者结合起来诊断CHD,则灵敏度、特异性、准确性分别为93.3%、90.9%、92.3%。结论在诊断CHD方面,CAC积分具有较高的灵敏度,DHCTA具有较高的特异性,将二者优势结合运用可进一步提高诊断的准确性。
Objective To evaluate the clinical value of double-slice spiral CT angiography (DHCTA) and coronary artery calcification (CAC) in the diagnosis of coronary heart disease (CHD). Methods Fifty-two patients with suspected CHD underwent coronary angiography (CAG). CAC integrals were detected by double-helical CT scan and parallel DHCTA scanning. The source images were input to HP4.1 workstation for multimodal three-dimensional reconstruction. CAG results as the gold standard to analyze DHCTA and CAC integral diagnostic performance of CHD. Results The sensitivity, specificity and accuracy of DHCTA and CAC were 70%, 90.9%, 78.8% and 93.3%, 63.6% and 80.8%, respectively. The sensitivity of DHCTA was lower than that of CAC, but the specificity was significantly higher than that of CAC, the difference was not statistically significant (P> 0.05). The combined diagnosis of CHD, the sensitivity, specificity, accuracy were 93.3%, 90.9%, 92.3%. Conclusion The CAC score has higher sensitivity in diagnosing CHD, and DHCTA has higher specificity. Combining the two advantages can further improve the diagnostic accuracy.