Carmo Miguel Mota, Ferreira Teresa, Quininha Jorge, Ferreira José
Serviço de Cardiologia, Hospital Pulido Valente, Lisboa, Portugal.
Rev Port Cardiol. 2005 May;24(5):667-79.
To evaluate the diagnostic accuracy of 16-slice multidetector spiral computed tomography in the non-invasive detection of coronary artery disease compared to invasive coronary angiography.
Prospective study.
We studied 35 patients, 21 men and 14 women, mean age 63.6+/-13.8 years, who underwent elective invasive coronary angiography one week prior to undergoing 16-slice multidetector computed tomography.
We used a Toshiba Aquilion 16-slice system. Helical acquisition was performed with breath holding after injection of 140 ml of a contrast agent into a peripheral vein. Cross-sectional images were reconstructed with a slice thickness of 0.5 mm or 1 mm. We set 15 anatomical segments for the coronary tree and the evaluation was performed independently for both techniques. Coronary artery lesions with over 50% reduction in diameter were considered significant. Findings from both techniques were evaluated using ROC curve analysis.
It was possible to evaluate 87.7% of the coronary tree segments; heavy calcification, enability to perform breath holding, motion artefacts and stents made evaluation of the other segments impossible. Overall sensitivity and specificity were 85.9% and 98.2% respectively with a 95 % confidence interval; positive predictive value was 87% and negative predictive value 97% For the different anatomical segments, sensitivity and specificity were: proximal 88.9% and 97.8%; medial 90.9% and 95.8%; distal 86.7% and 99.1% respectively.
Multidetector computed tomography is a promising non-invasive technique for detecting or ruling out significant coronary lesions.
与有创冠状动脉造影术相比，评估16层多排螺旋计算机断层扫描在冠状动脉疾病无创检测中的诊断准确性。
前瞻性研究。
我们研究了35例患者，其中男性21例，女性14例，平均年龄63.6±13.8岁，这些患者在接受16层多排计算机断层扫描前一周接受了选择性有创冠状动脉造影术。
我们使用东芝Aquilion 16层系统。在向外周静脉注射140毫升造影剂后屏气进行螺旋采集。横断面图像以0.5毫米或1毫米的层厚重建。我们为冠状动脉树设定了15个解剖节段，并对两种技术分别进行独立评估。直径减少超过50%的冠状动脉病变被认为是显著的。使用ROC曲线分析对两种技术的结果进行评估。
可以评估87.7%的冠状动脉树节段；严重钙化、无法屏气、运动伪影和支架使其他节段无法评估。总体敏感性和特异性分别为85.9%和98.2%，95%置信区间；阳性预测值为87%，阴性预测值为97%。对于不同的解剖节段，敏感性和特异性分别为：近端88.9%和97.8%；中间90.9%和95.8%；远端86.7%和99.1%。
多排计算机断层扫描是一种有前景的无创技术，可用于检测或排除显著的冠状动脉病变。
