上海交通大学学报（医学版）

›› 2009, Vol. 29 ›› Issue (11): 1371-.

• 论著（临床研究） • 上一篇    下一篇

64层螺旋CT联合平板运动试验对冠心病的诊断价值

李 辉, 武明辉, 宁培刚, 吕传剑, 马 波, 刘子伦   

  1. 河南省人民医院 放射科, 郑州 450003
  • 出版日期:2009-11-25 发布日期:2009-11-24
  • 作者简介:李 辉（1972—）, 男, 主治医师, 硕士；电子信箱: fangshekelh2000@163.com。

Diagnostic performance of 64-slice spiral CT combined with exercise treadmill test for coronary artery disease

LI Hui, WU Ming-hui, NING Pei-gang, LV Chuan-jian, MA bo, LIU Zi-lun   

  1. Department of Radiology, Henan Province People's Hospital, Zhengzhou 450003, China
  • Online:2009-11-25 Published:2009-11-24

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摘要：

目的 评价64层螺旋CT联合平板运动试验对冠心病的诊断价值。方法 86例疑似冠心病患者根据验前概率分为低危、中危和高危三组。所有患者均行冠状动脉造影、64层螺旋CT冠状动脉显像和平板运动试验。以冠状动脉造影作为“金标准”（冠状动脉狭窄>50%作为阳性结果），分别计算64层螺旋CT与64层螺旋CT联合平板运动试验对冠心病诊断的敏感性、特异性、阳性预测值、阴性预测值及准确率。结果 64层螺旋CT诊断冠心病的敏感性、特异性、阳性预测值、阴性预测值及准确率分别为95.2%、88.6%、88.9%、95.1%、91.9%。其中低危组、中危组和高危组的敏感性分别为100%、100%、92.6%；特异性为94.4%、94.1%、66.7%；阳性预测值为80.0%、91.7%、89.3%；阴性预测值为100%、100%、75.0%；准确率为95.5%、96.4%、86.1%。64层螺旋CT联合运动平板诊断冠心病的敏感性、特异性、阳性预测值、阴性预测值及准确率分别为97.6%、97.7%、97.6%、97.7%、97.7%。结论 64层螺旋CT联合平板运动试验对冠心病患者（尤其是验前概率低者）具有较高的筛选价值。

关键词: 计算机断层扫描, 64层, 平板运动, 冠心病, 冠状动脉造影, 诊断试验

Abstract:

Objective  To explore the diagnostic performance of 64-slice spiral CT combined with exercise treadmill test for coronary artery disease (CAD). Methods Eighty-six patients suspected of CAD were divided into low risk group, intermediate risk group and high risk group according to estimated pretest probabilities of CAD. All patients underwent coronary angiography, 64-slice spiral CT and exercise treadmill test. With coronary artery stenosis rate >50% as positive findings, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 64-slice spiral CT and 64-slice spiral CT combined with exercise treadmill test in diagnosis of CAD were calculated. Results With coronary angiography as the "golden criteria", the sensitivity, specificity, PPV, NPV and accuracy of 64-slice spiral CT in diagnosis of CAD were 95.2%, 88.6%, 88.9%, 95.1% and 91.9%, respectively. The sensitivity of low risk group, intermediate risk group and high risk group was 100%, 100% and 92.6%, specificity was 94.4%, 94.1% and 66.7%, PPV was 80.0%, 91.7% and 89.3%, NPV was 100%, 100% and 75.0%, and accuracy was 95.5%, 96.4% and 86.1%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of 64-slice spiral CT combined with exercise treadmill test in diagnosis of CAD were 97.6%, 97.7%, 97.6%, 97.7% and 97.7%, respectively. Conclusion 64-slice spiral CT combined with exercise treadmill test works well in screening CAD, especially for those with a low or intermediate estimated pretest probability.

Key words: computed tomography, 64-slice, exercise treadmill test, coronary artery disease, coronary angiography, diagnostic test