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薄层计算机断层扫描在检测冠状动脉狭窄中的准确性。

Accuracy of thin-slice computed tomography in the detection of coronary stenoses.

作者信息

Martuscelli Eugenio, Romagnoli Andrea, D'Eliseo Alessia, Razzini Cinzia, Tomassini Marco, Sperandio Massimiliano, Simonetti Giovanni, Romeo Francesco

机构信息

Department of Internal Medicine, Division of Cardiology, University of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy.

出版信息

Eur Heart J. 2004 Jun;25(12):1043-8. doi: 10.1016/j.ehj.2004.03.024.

Abstract

AIM

Our aim was to investigate the accuracy of multislice spiral computed tomography (MSCT) in the detection of significant (>50%) coronary stenosis using a scanner equipped for 16 x 0.625 mm collimation.

METHODS

In 64 patients (59 male, mean age 58 +/- 5 years) with suspected coronary artery disease, MSCT (GE Light Speed-16, collimation: 16 x 0.625 mm) was performed 20 +/- 5 days before coronary angiography (CAG). Only angiographic segments >1.5 mm were considered for analysis.

RESULTS

In all patients, MSCT was carried out without complications. Three patients were excluded from the analysis. Of 729 angiographic segments, 613 (84%) were judged evaluable by MSCT. Considering only the segments judged evaluable, the sensitivity was 89%, specificity 98%, positive predictive value 90%, and negative predictive value 98%. Including all segments in the analysis (evaluable and nonevaluable), sensitivity was 78%.

CONCLUSIONS

Using a scanner with a collimation of 16 x 0.625 mm, our study confirms the potential role of MSCT in the detection of significant coronary stenosis with a sensitivity of 89% and a very high specificity (98%). Exclusion criteria and less than full evaluability of the coronary arteries must still be considered limitations of the method.

摘要

目的

我们的目的是使用配备16×0.625mm准直器的扫描仪,研究多层螺旋计算机断层扫描(MSCT)检测显著(>50%)冠状动脉狭窄的准确性。

方法

对64例(59例男性,平均年龄58±5岁)疑似冠状动脉疾病患者,在冠状动脉造影(CAG)前20±5天进行MSCT(GE Light Speed-16,准直器:16×0.625mm)。仅对直径>1.5mm的血管造影节段进行分析。

结果

所有患者均顺利完成MSCT检查,无并发症发生。3例患者被排除在分析之外。在729个血管造影节段中,613个(84%)被判定可通过MSCT进行评估。仅考虑可评估节段,敏感性为89%,特异性为98%,阳性预测值为90%,阴性预测值为98%。将所有节段(可评估和不可评估)纳入分析时,敏感性为78%。

结论

使用准直器为16×0.625mm的扫描仪,我们的研究证实了MSCT在检测显著冠状动脉狭窄方面的潜在作用,其敏感性为89%,特异性非常高(98%)。排除标准和冠状动脉不完全可评估性仍必须被视为该方法的局限性。

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