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目的探讨多层螺旋CT(MSCT)冠脉造影(CA)对急性冠脉综合征(ACS)的临床诊断价值。方法对33例因胸痛而疑诊为ACS的患者行64层螺旋CT冠脉造影检查,并进行选择性冠状动脉造影(SAG)、心电图(ECG)检查。以SAG结果为“金标准”,比较其对ACS诊断的准确性。结果7例MSCT与SAG均排除冠脉狭窄病变。64层螺旋CT、ECG诊断中重度冠脉狭窄的敏感度分别为96·0%、88·0%;特异度为87·5%、37·5%;阳性预测值为96·0%、81·5%;阴性预测值为87·5%、50·0%。18例含有斑块,其中11例含软斑块,并进行了经皮冠状动脉腔内成形和支架植入术。结论64层螺旋CT冠脉造影对急性冠脉综合征患者是一种安全、可靠的无创性检查方法,并对内科介入治疗有指导价值。
Objective To investigate the clinical value of multi-slice spiral CT (MSCT) coronary angiography (CA) in the diagnosis of acute coronary syndrome (ACS). Methods Sixty-three patients with suspected ACS due to chest pain underwent coronary angiography and selective coronary angiography (SAG) and electrocardiogram (ECG). SAG results as the “gold standard”, compared with the accuracy of the diagnosis of ACS. Results Seven cases of MSCT and SAG excluded coronary artery stenosis. The sensitivity of 64-slice spiral CT and ECG in diagnosis of moderate and severe coronary artery stenosis were 96.0% and 88.0% respectively, the specificity was 87.5% and 37.5%, the positive predictive value was 96.0% and 81 · 5%; negative predictive value of 87.5%, 50.0%. Eighteen cases had plaques, of which 11 cases had soft plaques and underwent percutaneous transluminal coronary angioplasty and stent implantation. Conclusion 64-slice spiral CT coronary angiography is a safe and reliable non-invasive method for the diagnosis of acute coronary syndrome. It is instructive for interventional therapy.