超声联合CT或MRI在诊断冠状动脉疾病中的应用比较
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摘要
目的比较超声联合CT或MRI在诊断冠状动脉疾病中的应用价值。方法选取我院2015年8月至2017年8月69例临床怀疑冠状动脉疾病患者为研究对象,均在我院接受超声心动图、冠状动脉CTA、MRI检查及冠状动脉造影术。以冠状动脉造影结果为金标准,计算超声联合冠状动脉CTA或MRI诊断冠状动脉疾病的灵敏度、特异度、阳性预测值、阴性预测值、总符合率。结果共69例疑似冠状动脉疾病患者经冠状动脉造影术证实,管腔狭窄≥50%的冠状动脉共179支,管腔狭窄<50%的冠状动脉共97支。超声联合冠状动脉CTA诊断冠状动脉疾病的灵敏度、特异度、阳性预测值、阴性预测值、总符合率、Kappa值分别为89.4%、92.8%、95.8%、82.6%、90.6%、0.80。超声联合MRI诊断冠状动脉疾病的灵敏度、特异度、阳性预测值、阴性预测值、总符合率、Kappa值分别为92.7%、89.7%、94.3%、87.0%、91.7%、0.82。两种检查方案诊断冠状动脉疾病的灵敏度、特异度、阳性预测值、阴性预测值、总符合率比较差异无统计学意义(P>0.05)。结论超声联合冠状动脉CTA或MRI均可准确反映冠状动脉狭窄情况,为冠状动脉疾病的诊断提供影像学依据,可根据患者个人意愿与经济状况选择不同检查方法。
Objective To compare the value of ultrasound combined with coronary CT angiography or MRI in the diagnosis of coronary artery disease(CAD). Methods A total of 69 patients with suspected CAD who were admitted to the hospital from August 2015 to August 2017 were selected as subjects. All of them underwent echocardiography, coronary CT angiography, MRI examination and coronary angiography in the hospital. The sensitivity, specificity, positive predictive value, negative predictive value and total coincidence rate of ultrasound combined with coronary CT angiography or MRI in diagnosing CAD were calculated with results of coronary angiography as the golden standard. Results Coronaryangiography confirmed that there were a total of 179 coronary arteries with luminal stenosis of 50% or higher and 97 coronary arteries with luminal stenosis lower than 50%.The sensitivity, specificity, positive predictive value, negative predictive value, total coincidence rate and Kappa value of ultrasound combined with CT in diagnosing CAD were 89.4%, 92.8%, 95.8%, 82.6%, 90.6% and 0.80, respectively, while those of ultrasound combined with MRI were 92.7%, 89.7%, 94.3%, 87%, 91.7% and 0.82, respectively, without significant difference in the sensitivity, specificity, positive predictive value, negative predictive value or total coincidence rate between the two diagnostic schemes(P>0.05). Conclusion Ultrasound combined with coronary CT angiography or MRI can reflect the situation of coronary artery stenosis and provide imaging evidence for the diagnosis of CAD accurately. Different examination methods can be selected according to patient's intention and economic status.
Objective To compare the value of ultrasound combined with coronary CT angiography or MRI in the diagnosis of coronary artery disease(CAD). Methods A total of 69 patients with suspected CAD who were admitted to the hospital from August 2015 to August 2017 were selected as subjects. All of them underwent echocardiography, coronary CT angiography, MRI examination and coronary angiography in the hospital. The sensitivity, specificity, positive predictive value, negative predictive value and total coincidence rate of ultrasound combined with coronary CT angiography or MRI in diagnosing CAD were calculated with results of coronary angiography as the golden standard. Results Coronaryangiography confirmed that there were a total of 179 coronary arteries with luminal stenosis of 50% or higher and 97 coronary arteries with luminal stenosis lower than 50%.The sensitivity, specificity, positive predictive value, negative predictive value, total coincidence rate and Kappa value of ultrasound combined with CT in diagnosing CAD were 89.4%, 92.8%, 95.8%, 82.6%, 90.6% and 0.80, respectively, while those of ultrasound combined with MRI were 92.7%, 89.7%, 94.3%, 87%, 91.7% and 0.82, respectively, without significant difference in the sensitivity, specificity, positive predictive value, negative predictive value or total coincidence rate between the two diagnostic schemes(P>0.05). Conclusion Ultrasound combined with coronary CT angiography or MRI can reflect the situation of coronary artery stenosis and provide imaging evidence for the diagnosis of CAD accurately. Different examination methods can be selected according to patient's intention and economic status.
引文
[1]周洁欣,韩辉武,唐旸烁.冠心病患者血清胱抑素含量与心肌缺血关系研究[J].湖南师范大学学报(医学版),2017,14(5):30-33.
[2]应丹央.血清胱抑素C和N端脑钠肽前体水平与冠心病患者冠状动脉病变程度的相关性研究[J].中国基层医药,2017,24(15):2246-2249.
[3]高珊,张湘瑜,张景昌,等.不同温度对比剂对老年糖尿病患者冠状动脉造影术后对比剂肾病发生率的影响[J].医学临床研究,2016,33(6):1081-1085.
[4]李宜嘉,杨娅,聂绍平,等.超声心动图无创诊断冠状动脉慢血流现象可行性研究[J].中国超声医学杂志,2017,33(2):107-109.
[5]林蓓佑,巫相宏.超声心动图对冠心病的诊断价值[J].临床心血管病杂志,2015,31(4):440-442.
[6]陈晓亮,陈馨亮,张素琴,等.多层螺旋CT对老年糖尿病患者冠状动脉病变筛查的研究[J].中华老年医学杂志,2017,36(9):963-965.
[7]孙宇姣,俞鑫,耿松,等.应用多排螺旋CT评估冠心病危险因素与冠状动脉病变程度的关系[J].中华医学杂志,2016,96(39):3133-3136.
[8]吕滨.积极推进心脏冠状动脉CT技术规范化应用[J].中华放射学杂志,2017,51(10):723-724.
[9]王建花.MDCT与MRI在冠心病诊断中的现状与进展[J].实用放射学杂志,2017,33(5):791-794.
[10]马梅,尹浩晔,贾文军,等.不同冠状动脉评分方法评价冠心病严重程度的关系研究[J].中国循环杂志,2007,22(5):340-342.
[11]韩迎春,樊刚,曹文广,等.64层螺旋CT冠脉成像与DSA血管造影在疾病中诊断价值的比较分析[J].中国CT和MRI杂志,2016,14(1):56-58.
[12]李全,曾祥军,胡春明,等.64层螺旋CT冠状动脉CTA在冠状动脉疾病诊断中的应用[J].实用放射学杂志,2015,31(1):165-167.
[13]卢伟光,曾怡群,赖焕泉,等.64排CT诊断冠状动脉易损斑块的临床价值及危险因素分析[J].中国CT和MRI杂志,2017,15(6):37-40.
[14]王守亮.冠状动脉易损斑块评价方法研究进展[J].山东医药,2015,55(10):100-102.
[2]应丹央.血清胱抑素C和N端脑钠肽前体水平与冠心病患者冠状动脉病变程度的相关性研究[J].中国基层医药,2017,24(15):2246-2249.
[3]高珊,张湘瑜,张景昌,等.不同温度对比剂对老年糖尿病患者冠状动脉造影术后对比剂肾病发生率的影响[J].医学临床研究,2016,33(6):1081-1085.
[4]李宜嘉,杨娅,聂绍平,等.超声心动图无创诊断冠状动脉慢血流现象可行性研究[J].中国超声医学杂志,2017,33(2):107-109.
[5]林蓓佑,巫相宏.超声心动图对冠心病的诊断价值[J].临床心血管病杂志,2015,31(4):440-442.
[6]陈晓亮,陈馨亮,张素琴,等.多层螺旋CT对老年糖尿病患者冠状动脉病变筛查的研究[J].中华老年医学杂志,2017,36(9):963-965.
[7]孙宇姣,俞鑫,耿松,等.应用多排螺旋CT评估冠心病危险因素与冠状动脉病变程度的关系[J].中华医学杂志,2016,96(39):3133-3136.
[8]吕滨.积极推进心脏冠状动脉CT技术规范化应用[J].中华放射学杂志,2017,51(10):723-724.
[9]王建花.MDCT与MRI在冠心病诊断中的现状与进展[J].实用放射学杂志,2017,33(5):791-794.
[10]马梅,尹浩晔,贾文军,等.不同冠状动脉评分方法评价冠心病严重程度的关系研究[J].中国循环杂志,2007,22(5):340-342.
[11]韩迎春,樊刚,曹文广,等.64层螺旋CT冠脉成像与DSA血管造影在疾病中诊断价值的比较分析[J].中国CT和MRI杂志,2016,14(1):56-58.
[12]李全,曾祥军,胡春明,等.64层螺旋CT冠状动脉CTA在冠状动脉疾病诊断中的应用[J].实用放射学杂志,2015,31(1):165-167.
[13]卢伟光,曾怡群,赖焕泉,等.64排CT诊断冠状动脉易损斑块的临床价值及危险因素分析[J].中国CT和MRI杂志,2017,15(6):37-40.
[14]王守亮.冠状动脉易损斑块评价方法研究进展[J].山东医药,2015,55(10):100-102.