[1]蔡巍巍,胡杰*①,陈嵩.冠状动脉计算机断层血管造影在主动脉瓣置换术前筛查冠心病中的应用[J].中国微创外科杂志,2018,18(3):252-255.
　Cai Weiwei*,Hu Jie,Chen Song*..Application of Computed Tomography Angiography in Evaluation of Coronary Heart Disease Before Aortic Valve Replacement[J].Chinese Journal of Minimally Invasive Surgery,2018,18(3):252-255.
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冠状动脉计算机断层血管造影在主动脉瓣置换术前筛查冠心病中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年3期
页码:
252-255
栏目:
影像学研究
出版日期:
2018-05-01

文章信息/Info

Title:
Application of Computed Tomography Angiography in Evaluation of Coronary Heart Disease Before Aortic Valve Replacement
作者:
蔡巍巍; 胡杰*①; 陈嵩
郑州大学附属洛阳中心医院心脏大血管外科，洛阳471009
Author(s):
Cai Weiwei*;  Hu Jie;  Chen Song*.
*Department of Cardiovascular Surgery, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang 471009, China
关键词:
计算机断层血管造影; 冠心病; 主动脉瓣置换术
Keywords:
Computed tomography angiography; Coronary heart disease; Aortic valve replacement
文献标志码:
A
摘要:
目的探讨主动脉瓣置换术前冠状动脉计算机断层血管造影（computed tomography angiography，CTA）对冠心病诊断的准确性。方法选取2011年1月~2015年12月我院老年主动脉瓣瓣膜病150例，心电图示ST-T改变，均在术前行冠状动脉CTA、冠状动脉造影（coronary angiography，CAG）检查，以CAG结果为标准，分析 CTA诊断的敏感性、特异性、阳性预测值及阴性预测值。结果冠状动脉狭窄程度超过50%的患者CTA敏感性、特异性、阳性预测值、阴性预测值分别为97.4%（115/118）、87.5%（28/32）、96.6%（115/119）、90.3%（28/31），以冠状动脉受累数量分析分别为96.7%（323/334）、61.3%（163/266）、75.8%（323/426）、93.7%（163/174）。冠状动脉狭窄程度超过75%的患者CTA敏感性、特异性、阳性预测值、阴性预测值分别为100.0%（52/52）、67.3%（66/98）、61.9%（52/84）、100.0%（66/66），以冠状动脉受累情况分析分别为98.2%（166/169）、64.3%（277/431）、51.9%（166/320）、98.9%（277/280）。 结论冠状动脉CTA可用于AVR患者术前筛查，对于CTA未能发现明确冠状动脉狭窄的患者，可不必再行CAG检查。
Abstract:
ObjectiveTo discuss the accuracy of computed tomography angiography (CTA) in the diagnosis of coronary heart disease before aortic valve replacement (AVR).MethodsA total of 150 elderly aortic valve disease patients from January 2011 to December 2015 were investigated. The ECG showed STT changes. All the patients underwent coronary angiography (CAG) and CTA preoperation. With the results of CAG as a golden standard, the sensitivity, specificity, positive predictive value and negative predictive value of CTA were analyzed.ResultsIn patients with more than 50% stenosis, the sensitivity, specificity, positive predictive value, and negative predictive value were 97.4%(115/118), 87.5%(28/32), 96.6%(115/119), and 90.3%(28/31), respectively. According to the number of involved coronary artery, the sensitivity, specificity, positive predictive value, and negative predictive value were 97.4% (115/118), 87.5% (28/32), 96.6% (115/119), and 90.3% (28/31), respectively. In patients with more than 75% stenosis, the sensitivity, specificity, positive predictive value, and negative predictive value were 1000% (52/52), 67.3% (66/98), 61.9% (52/84), and 100.0% (66/66), respectively. According to the number of involved coronary artery, the sensitivity, specificity, positive predictive value, and negative predictive value were 98.2%(166/169), 64.3%(277/431), 51.9%(166/320), and 98.9%(277/280), respectively.ConclusionCoronary CTA can be reliably used for screening before AVR. For patients with negative findings by CTA, CAG is not necessary.

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备注/Memo

备注/Memo:
*通讯作者，E-mail：13721624858@163.com①麻醉科
更新日期/Last Update: 2018-05-10