Kuettner Axel, Trabold Tobias, Schroeder Stephen, Feyer Anja, Beck Torsten, Brueckner Ariane, Heuschmid Martin, Burgstahler Christof, Kopp Andreas F, Claussen Claus D
Department for Radiology, Diagnostic Radiology, Eberhard-Karls-University of Tuebingen, Tuebingen, Germany.
J Am Coll Cardiol. 2004 Sep 15;44(6):1230-7. doi: 10.1016/j.jacc.2004.05.079.
The aim of our study was to evaluate the feasibility of detecting coronary artery lesions using a new computed tomography (CT) scanner with 16 detectors and faster gantry rotation.
Computed tomography angiography of the coronaries permits assessment of the coronaries; however, image quality is still impaired by motion artifacts and calcifications.
Sixty patients scheduled for conventional coronary angiography (CCA) were additionally studied by multislice spiral computed tomography (MSCT). Calcium scores and a contrast-enhanced visualization of the coronaries were performed and analyzed regarding evaluability, presence of coronary artery lesions, and correct clinical diagnosis.
Calcium scoring was successful in all patients; 58 of 60 patients had a diagnostic contrast-enhanced scan. Mean calcium score was 506 +/- 743 Agatston score equivalent (ASE); 13 of 58 (22%) patients had an ASE >or=1,000, 46 of 58 (78%) patients <1,000. In 763 coronary segments, CCA detected a total of 75 lesions >or=50%. The MSCT correctly assessed 54 of these. Twenty-one lesions were missed or incorrectly underestimated. Sensitivity was 72%, specificity 97%. When restricting analysis to patients with an ASE <1,000, 40 significant lesions >or=50% were seen on CCA, and MSCT correctly detected 39 lesions (sensitivity 98%, specificity 98%). Regardless of any threshold, the correct clinical diagnosis could be obtained in 58 of 60 (97%) of all patients.
In individuals with low-to-moderate amounts of coronary artery calcium, 16-detector CT coronary angiography has high sensitivity and specificity for the diagnosis of significant coronary artery stenosis.
我们研究的目的是评估使用具有16排探测器且机架旋转更快的新型计算机断层扫描（CT）扫描仪检测冠状动脉病变的可行性。
冠状动脉计算机断层血管造影术可用于评估冠状动脉；然而，图像质量仍受运动伪影和钙化的影响。
对60例计划进行传统冠状动脉造影（CCA）的患者额外进行多层螺旋计算机断层扫描（MSCT）研究。进行了钙化评分以及冠状动脉的对比增强显影，并就可评估性、冠状动脉病变的存在情况及正确的临床诊断进行分析。
所有患者的钙化评分均成功完成；60例患者中有58例进行了具有诊断价值的对比增强扫描。平均钙化评分为506±743阿加斯顿评分当量（ASE）；58例患者中有13例（22%）ASE≥1000，58例患者中有46例（78%）＜1000。在763个冠状动脉节段中，CCA共检测到75个≥50%的病变。MSCT正确评估了其中的54个。21个病变被漏诊或错误低估。敏感性为72%，特异性为97%。当将分析限于ASE＜1000的患者时，CCA上可见40个≥50%的显著病变，MSCT正确检测到39个病变（敏感性98%，特异性98%）。无论采用何种阈值，60例患者中有58例（97%）可获得正确的临床诊断。
在冠状动脉钙化程度为低至中度的个体中，16排CT冠状动脉造影对显著冠状动脉狭窄的诊断具有高敏感性和特异性。
