南方医科大学学报

南方医科大学学报 ›› 2013, Vol. 33 ›› Issue (06): 819-.

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静息状态下CT冠状动脉造影结合CT首过心肌灌注成像诊断阻塞性冠脉病变

汪奇，秦静，盖鲁粤，王志国，关志伟，孙志军，董蔚，杨立，陈韵岱   

  • 出版日期:2013-06-20 发布日期:2013-06-20

Diagnosis of obstructive coronary artery disease using CT coronary angiography combined with CT first-pass myocardial perfusion imaging at rest

  • Online:2013-06-20 Published:2013-06-20

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摘要： 目的探讨静息状态下CT冠状动脉造影（CTCA）结合CT首过心肌灌注成像（CT first-pass MPI）全面诊断冠心病的临床可
行性与准确性。方法55 例怀疑或诊断为冠心病的患者，两周内完成CTCA与CAG检查。应用CTCA的原始数据进行CT
first-pass MPI分析，以CAG结果为参照，评价CT first-pass MPI及CTCA结合CT first-pass MPI检测阻塞性冠脉病变的准确
性。结果以CAG结果作为参照，CT first-pass MPI检测阻塞性冠脉病变的敏感性为84.6%，特异性为68.8%，阳性预测值为
86.8%，阴性预测值为64.7%，准确性为80.0%；CTCA结合CT first-pass MPI诊断阻塞性冠脉病变的敏感性为92.3%，特异性为
93.8%，阳性预测值为97.3%，阴性预测值为83.3%，准确性为92.7%。结论静息状态下CTCA结合CT first-pass MPI方法可以
同时提供冠脉解剖学及功能学方面的信息，临床可行，且可准确的诊断阻塞性冠脉疾病。

Abstract: Objective To assess the feasibility and accuracy of CT coronary angiography (CTCA) combined with CT first-pass
myocardial perfusion imaging (CT first-pass MPI) at rest for diagnosis of obstructive coronary artery disease (CAD). Methods
Fifty-five patients, suspected or diagnosed as CAD, were performed with CTCA and CAG within 2 weeks. CT first-pass MPI
detected myocardial ischemia through analyzing the raw date of CTCA. Results Comparison with the results of CAG, the
sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of CT first-pass MPI at
rest for detecting obstructive CAD were 84.6%, 68.8%, 86.8%, 64.7% and 80.0%, respectively; and 92.3%, 93.8%, 97.3%, 83.3%,
92.7% for CTCA combined with CT first-pass MPI, respectively. Conclusions CTCA combined with CT first-pass MPI at rest
could detect obstructive CAD feasibly and accurately.