Janssen Caroline H C, Kuijpers Dirkjan, Vliegenthart Rozemarijn, Overbosch Jelle, van Dijkman Paul R M, Zijlstra Felix, Oudkerk Matthijs
Department of Radiology, University Hospital Groningen, The Netherlands.
Eur Radiol. 2005 Jun;15(6):1128-34. doi: 10.1007/s00330-005-2706-0. Epub 2005 Feb 24.
The aim of this study was to determine whether a coronary artery calcium (CAC) score of less than 11 can reliably rule out myocardial ischemia detected by dobutamine cardiovascular magnetic resonance imaging (CMR) in patients suspected of having myocardial ischemia. In 114 of 136 consecutive patients clinically suspected of myocardial ischemia with an inconclusive diagnosis of myocardial ischemia, dobutamine CMR was performed and the CAC score was determined. The CAC score was obtained by 16-row multidetector compued tomography (MDCT) and was calculated according to the method of Agatston. The CAC score and the results of the dobutamine CMR were correlated and the positive predictive value (PPV) and the negative predictive value (NPV) of the CAC score for dobutamine CMR were calculated. A total of 114 (87%) of the patients were eligible for this study. There was a significant correlation between the CAC score and dobutamine CMR (p<0.001). Patients with a CAC score of less than 11 showed no signs of inducible ischemia during dobutamine CMR. For a CAC score of less than 101, the NPV and the PPV of the CAC score for the outcome of dobutamine CMR were, respectively, 0.96 and 0.29. In patients with an inconclusive diagnosis of myocardial ischemia a MDCT CAC score of less than 11 reliably rules out myocardial ischemia detected by dobutamine CMR.
本研究的目的是确定冠状动脉钙化（CAC）评分低于11时，能否可靠地排除疑似心肌缺血患者经多巴酚丁胺心血管磁共振成像（CMR）检测出的心肌缺血。在136例临床疑似心肌缺血且心肌缺血诊断不明确的连续患者中，114例进行了多巴酚丁胺CMR检查并确定了CAC评分。CAC评分通过16排多层螺旋计算机断层扫描（MDCT）获得，并根据阿加斯顿方法计算。将CAC评分与多巴酚丁胺CMR结果进行相关性分析，并计算CAC评分对多巴酚丁胺CMR的阳性预测值（PPV）和阴性预测值（NPV）。共有114例（87%）患者符合本研究条件。CAC评分与多巴酚丁胺CMR之间存在显著相关性（p<0.001）。CAC评分低于11的患者在多巴酚丁胺CMR期间未显示出诱导性缺血的迹象。对于CAC评分低于101的情况，CAC评分对多巴酚丁胺CMR结果的NPV和PPV分别为0.96和0.29。在心肌缺血诊断不明确的患者中，MDCT CAC评分低于11可可靠地排除多巴酚丁胺CMR检测出的心肌缺血。
