微创医学2026，Vol.21Issue(2)：178-183,6.DOI:10.11864/j.issn.1673.2026.02.07
柔性减影冠状动脉CT血管成像诊断冠状动脉狭窄的效能
Diagnostic efficacy of subtraction-coronary computed tomographic angiography for coronary artery stenosis
摘要
Abstract
Objective To evaluate the diagnostic efficacy of subtraction-coronary computed tomographic angiography(Sub-CCTA)for coronary artery stenosis.Methods A total of 40 patients with suspected coronary heart disease(356 coronary artery segments)were enrolled as study subjects.All patients underwent digital subtraction angiography(DSA)and coronary computed tomographic angiography(CCTA),followed by Sub-CCTA image processing.Taking DSA as the reference standard,the diagnostic efficacy of CCTA and Sub-CCTA for coronary artery stenosis was evaluated.And the diagnostic consistency was assessed using the Kappa test.Results There was no statistically significant difference in the detection rate of coronary artery stenosis among CCTA,Sub-CCTA and DSA(P>0.05).However,CCTA and Sub-CCTA showed a higher detection rate for mild stenosis but a lower detection rate for severe stenosis than DSA(P<0.05).Using DSA as the reference standard,CCTA showed moderate agreement with DSA in diagnosing coronary artery stenosis(Kappa=0.468),while Sub-CCTA showed good agreement(Kappa=0.706).Of the 356 coronary artery segments,204 segments with plaques were detected by CCTA.There was a statistically significant difference in the detection rate of coronary artery stenosis with plaques between CCTA and Sub-CCTA(P<0.05).Among them,the stenosis detection rate of CCTA was higher than that of Sub-CCTA in coronary artery segments with calcified plaques and mixed plaques(P<0.05),whereas no statistically significant difference was found between CCTA and Sub-CCTA in coronary artery segments with non-calcified plaques(P>0.05).Using DSA as the reference standard,CCTA showed poor agreement with DSA in diagnosing coronary artery stenosis with plaques(Kappa=0.223),whereas Sub-CCTA showed moderate agreement(Kappa=0.618).Conclusion The detection rates of coronary artery stenosis by CCTA and Sub-CCTA were comparable to those by DSA.CCTA showed moderate agreement with DSA in diagnosing coronary artery stenosis,whereas Sub-CCTA showed good agreement.In the presence of coronary artery plaques,Sub-CCTA demonstrated superior diagnostic efficacy for coronary artery stenosis compared with CCTA.关键词
冠状动脉狭窄/冠状动脉CT血管成像/柔性减影技术/数字减影血管造影/冠状动脉斑块Key words
Coronary artery stenosis/Coronary computed tomographic angiography/Flexible subtraction technique/Digital subtraction angiography/Coronary artery plaque引用本文复制引用
杨艳云,李传,陈燕清..柔性减影冠状动脉CT血管成像诊断冠状动脉狭窄的效能[J].微创医学,2026,21(2):178-183,6.基金项目
广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z-A202220176) （编号:Z-A202220176）
