【摘要】 目的 探讨16层螺旋CT冠状动脉造影对心电图正常的胸痛患者的诊断价值。方法 对52例临床怀疑冠心病、心绞痛而无发作时心电图ST段改变的患者行16层螺旋CT冠状动脉造影和经皮选择性冠状动脉造影术。对16层螺旋CT显示冠状动脉狭窄和经皮选择性冠状动脉造影显示冠状动脉狭窄进行定量评价。以经皮选择性冠状动脉造影结果作为诊断金标准。计算出16层螺旋CT冠状动脉成像对冠状动脉狭窄的诊断准确性指标。结果 16层螺旋CT冠状动脉造影对照经皮选择性冠状动脉造影对冠状动脉中、重度狭窄显示的对照结果：敏感性83.05%、特异性95.97%、阳性预测值89.09%、阴性预测值93.46%、准确度92.31%。结论 16层螺旋CT冠状动脉造影对心电图正常的胸痛患者具有良好的诊断价值，并可对冠状动脉形态学进行良好的评价，从而进行介入治疗的筛选。但并不能完全取代传统的经皮选择性冠状动脉造影术。

    【关键词】 16层螺旋CT；回顾性心电门控；胸痛；心电图；冠状动脉造影

    Diagnostic value of coronary angiography with sixteen slice spiral CT in chest pain patients with normal electrocardiogram

    SHI Qi-song,WANG Xi-zhuo,WEI Fang,et al.

    The Second Hospital of Baoding,Baoding 071051,Hebei

    【Abstract】 Objective To evaluate the diagnostic value of sixteen slice spiral CT in chest pain patients with normal electrocardiogram.Methods 52 patients of suspected angina pectoris without ST-segment evolvement underwent sixteen slice spiral CT coronary angiography and conventional percutaneous coronary angiography.Then coronary artery stenosis were quantitatively assessed.We considered the result of percutaneous coronary angiography the gold standard and compared results of the two different diagnostic methods to determine the accuracy of 16 slice spiral CT.Results Compared with percutaneous coronary angiography,the sensitivity of sixteen slice sparil CT in diagnosing moderate and severe coronary stenosis was 83.05%,and the specificness,positive predictive value,negative predictive value and degree of accuracy was 95.97%,89.09%,93.46% and 92.31% respectively.Conclusion Sixteen slice spiral CT coronary angiography has clinical value in diagnosing chest pain patients with normal electrocardiogram and can provide informations about coronary morphology for advanced interventional therapy.However,its diagnostic accuracy is limited and it can’t replace the conventional percutaneous coronary angiography at present. ......