Kostkiewicz Magdalena, Szot Wojciech M, Pasowicz Mieczysław, Konieczyńska Małgorzata, Kabłak-Ziembicka Anna, Podolec Piotr, Tracz Wiesława
Klinika Chorób Serca i Naczyń, Instytut Kardiologii Collegium Medicum, Uniwersytetu Jagiellońskiego, Kraków.
Przegl Lek. 2004;61(6):690-4.
There is growing evidence regarding evaluation of Coronary Artery Calcium Score (CS) using the multi-slice computer tomography (MSCT), but as a new method it still need for verification in comparison with other, non-invasive modalities, with established rationale. One of these is SPECT, which value in evaluation of patients with coronary artery disease is well known. We tried to compare these two studies and their usefulness in diagnosis of patients with confirmed coronary artery disease.
72 patients (53 males and 19 females, mean age 59.9 +/- 8.66), all after coronary angiography, with coronary artery disease (CCS II or III) were included into our study. SPECT and exercise treadmill results were compared with the coronary artery calcium score (CS) as assessed by MSCT. Both studies were performed with maximal 7-days intervals at most between the studies. Image reconstruction was performed using the Autoperfusion protocol, with the VISUAL Score analysis (5-point scale) of extent of perfusion defect. MSCT was evaluated using the Calcium Score protocol. For the statistical analysis we used Student's T-test and Pearson correlation analysis.
The correlation between total CS and the score of the reversible and non-reversible perfusion defects in Tc 99mMIBI SPECT was not found. Following the analysis for the 3 main coronary arteries separately, and number of perfusion defects, a correlation was observed for LAD and RCA perfusion regions.
关于使用多层计算机断层扫描（MSCT）评估冠状动脉钙化评分（CS）的证据越来越多，但作为一种新方法，与其他具有既定理论基础的非侵入性检查方法相比，仍需验证。其中之一是单光子发射计算机断层扫描（SPECT），其在评估冠心病患者方面的价值是众所周知的。我们试图比较这两种检查及其在确诊冠心病患者诊断中的有用性。
72例患者（53例男性和19例女性，平均年龄59.9±8.66岁），均在冠状动脉造影术后，患有冠心病（CCS II级或III级），被纳入我们的研究。将SPECT和运动平板试验结果与MSCT评估的冠状动脉钙化评分（CS）进行比较。两项检查之间的间隔时间最长为7天。使用自动灌注协议进行图像重建，并对灌注缺损范围进行视觉评分分析（5分制）。使用钙化评分协议对MSCT进行评估。对于统计分析，我们使用了学生t检验和Pearson相关性分析。
未发现总CS与锝99m甲氧基异丁基异腈（Tc 99mMIBI）SPECT中可逆和不可逆灌注缺损评分之间的相关性。分别对3条主要冠状动脉和灌注缺损数量进行分析后，观察到左前降支（LAD）和右冠状动脉（RCA）灌注区域存在相关性。
1.发现MSCT测量的CS与左前降支（LAD）和右冠状动脉（RCA）灌注区域的SPECT灌注缺损之间存在统计学显著相关性。2.发现高CS（>400）与冠状动脉造影中血流动力学显著变化的存在之间存在相关性。3.我们得出结论，MSCT测量的CS可能是一种具有一定价值的风险分层筛查工具。
