Stanford William, Thompson Brad H, Burns Trudy L, Heery Scot D, Burr Mary C
Department of Radiology, College of Medicine, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242, USA.
Radiology. 2004 Feb;230(2):397-402. doi: 10.1148/radiol.2302020901.
To compare coronary artery calcium scores from a multi-detector row helical computed tomographic (CT) scanner with those from an electron-beam CT scanner, with emphasis on subjects with calcium scores less than 400.
Seventy-eight asymptomatic subjects (37 women, 41 men; age range, 39-78 years; mean age, 54.2 years) underwent multi-detector row CT and electron-beam CT. Volume and Agatston scores were calculated with a workstation. Statistical analyses included assessment of association between calcium scores from two scanners, calculation of percent absolute difference to assess score variability between scanners, equivalence analysis, construction of Bland-Altman plots to assess agreement between scores, and assessment of changes in score grouping and risk criteria based on score differences between scanners.
Electron-beam CT calcium scores were higher than multi-detector row CT scores. Linear association between calcium scores obtained from paired scans was significant (r = 0.96-0.99, P <.001). Mean percent absolute differences were 67.9% and 65.0% for volume and Agatston scores, respectively (48.6% and 46.3% for corresponding natural log-transformed scores). In subjects with a score of 11 or greater, mean percent absolute differences between electron-beam CT and multi-detector row CT scores ranged from 15% to 30% (<10% for natural log-transformed calcium scores). With a 20% equivalence limit, calcium scores from the two scanners were statistically equivalent (P <.05). Score grouping would have been subject to change in 12 (11 increased and one decreased; six with scores of 11 or greater), and possible risk management decisions would have been subject to change in eight (16%) of 51 subjects who underwent electron-beam CT versus multi-detector row CT scanning.
Multi-detector row CT appears to be comparable to electron-beam CT for coronary calcification screening, except in subjects with a calcium score less than 11.
比较多排螺旋计算机断层扫描（CT）扫描仪与电子束CT扫描仪得出的冠状动脉钙化积分，重点关注钙化积分低于400的受试者。
78名无症状受试者（37名女性，41名男性；年龄范围39 - 78岁；平均年龄54.2岁）接受了多排CT和电子束CT检查。使用工作站计算容积积分和阿加斯顿积分。统计分析包括评估两种扫描仪得出的钙化积分之间的相关性、计算绝对差异百分比以评估扫描仪之间积分的变异性、等效性分析、构建布兰德-奥特曼图以评估积分之间的一致性，以及基于扫描仪之间的积分差异评估积分分组和风险标准的变化。
电子束CT钙化积分高于多排CT积分。配对扫描得出的钙化积分之间存在显著的线性相关性（r = 0.96 - 0.99，P <.001）。容积积分和阿加斯顿积分的平均绝对差异百分比分别为67.9%和65.0%（相应自然对数转换积分的平均绝对差异百分比为48.6%和46.3%）。在积分≥11的受试者中，电子束CT与多排CT积分之间的平均绝对差异百分比在15%至30%之间（自然对数转换钙化积分<10%）。设定20%的等效性界限时，两种扫描仪得出的钙化积分在统计学上等效（P <.05）。积分分组在12名受试者中可能会发生变化（11名增加，1名减少；6名积分≥11），在接受电子束CT与多排CT扫描的51名受试者中，可能的风险管理决策在8名（16%）受试者中会发生变化。
除了钙化积分低于11的受试者外，多排CT在冠状动脉钙化筛查方面似乎与电子束CT相当。
