| 孙龙,官泳松 审校.多层螺旋CT诊断冠状动脉疾病的发展趋势[J].中国医学影像技术,2007,23(7):1092~1096 |
| 多层螺旋CT诊断冠状动脉疾病的发展趋势 |
| Multidetector spiral CT in the diagnosis of coronary artery disease: prospective |
| 投稿时间：2007-01-15 修订日期：2007-06-13 |
| DOI： |
| 中文关键词: 冠状动脉疾病 冠状血管造影 体层摄影术,X线计算机 |
| 英文关键词:Coronary artery disease CT coronary angiography Tomography, X-ray coputed |
| 基金项目: |
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| 中文摘要: |
| 多层螺旋CT(multidetector spiral computed tomography, MDCT)在CAD诊断领域的主要适应证有:测定冠状动脉钙化积分(coronary artery calcium score, CACS)、CT冠状动脉造影、评价心肌功能及冠心病(coronary artery disease, CAD)在治疗后的随访。据报道,CACS用于诊断CAD的敏感性范围在68.0%~100%,特异性范围在21.0%~100%。高CACS是一个敏感性很高但特异性相对较低的指标,与常规冠状动脉造影(coronary angiography, CAG)相比,16排MDCT的冠状动脉造影在诊断冠状动脉狭窄(350%)时具有中高度敏感性和高度阴性预测值(negative predictive value, NPV)。与之相比,64排MDCT的敏感性和NPV 更高,但特异性与阳性预测值(positive predictive value, PPV)却无明显提高。将冠状动脉形态学与心肌灌注功能研究相结合,是今后CAD的研究方向。 |
| 英文摘要: |
| The clinical indications of multidetector spiral CT (MDCT) to coronary artery disease (CAD) include (coronary artery calcium score, CACS), CT coronary angiography, myocardial function investigation, and the follow-up after CAD treatment. The sensitivity and specificity of CACS for the detection of significant CAD have been reported as 68.0%~100% and 21.0%~100%, respectively. CACS has a high sensitivity but a relatively low specificity to CAD. 16-MDCT shows a moderate to high sensitivity and high negative predictive value (NPV) for the detection or exclusion of the vessels with significant lesions, but has a low positive predictive value (PPV) compared with CAG. 64-MDCT has a higher sensitivity and NPV than 16-MDCT, but specificity and PPV are not much improved. MDCT has been also used to identify coronary artery plaque. Combination of functional with anatomical studies will be a new approach of MDCT imaging for an integrated research of CAD diagnosis and evaluation. |
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