Ehara Mariko, Surmely Jean-Francois, Kawai Masato, Katoh Osamu, Matsubara Tetsuo, Terashima Mitsuyasu, Tsuchikane Etsuo, Kinoshita Yoshihisa, Suzuki Tomomichi, Ito Tatsuya, Takeda Yoshihiro, Nasu Kenya, Tanaka Nobuyoshi, Murata Akira, Suzuki Yasuyuki, Sato Koyo, Suzuki Takahiko
Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan.
Circ J. 2006 May;70(5):564-71. doi: 10.1253/circj.70.564.
Multislice computed tomography (MSCT) is a promising noninvasive method of detecting coronary artery disease (CAD). However, most data have been obtained in selected series of patients. The purpose of the present study was to investigate the accuracy of 64-slice MSCT (64 MSCT) in daily practice, without any patient selection.
Using 64-slice MSCT coronary angiography (CTA), 69 consecutive patients, 39 (57%) of whom had previously undergone stent implantation, were evaluated. The mean heart rate during scan was 72 beats/min, scan time 13.6 s and the amount of contrast media 72 mL. The mean time span between invasive coronary angiography (ICAG) and CTA was 6 days. Significant stenosis was defined as a diameter reduction of > 50%. Of 966 segments, 884 (92%) were assessable. Compared with ICAG, the sensitivity of CTA to diagnose significant stenosis was 90%, specificity 94%, positive predictive value (PPV) 89% and negative predictive value (NPV) 95%. With regard to 58 stented lesions, the sensitivity, specificity, PPV and NPV were 93%, 96%, 87% and 98%, respectively. On the patient-based analysis, the sensitivity, specificity, PPV and NPV of CTA to detect CAD were 98%, 86%, 98% and 86%, respectively. Eighty-two (8%) segments were not assessable because of irregular rhythm, calcification or tachycardia.
Sixty-four-MSCT has a high accuracy for the detection of significant CAD in an unselected patient population and therefore can be considered as a valuable noninvasive technique.
多层螺旋计算机断层扫描（MSCT）是一种很有前景的检测冠状动脉疾病（CAD）的非侵入性方法。然而，大多数数据是在特定的患者系列中获得的。本研究的目的是在日常实践中，不进行任何患者选择，研究64层MSCT（64 MSCT）的准确性。
使用64层MSCT冠状动脉造影（CTA）对69例连续患者进行评估，其中39例（57%）先前接受过支架植入术。扫描期间的平均心率为72次/分钟，扫描时间为13.6秒，造影剂用量为72毫升。有创冠状动脉造影（ICAG）与CTA之间的平均时间间隔为6天。显著狭窄定义为直径减少>50%。在966个节段中，884个（92%）可评估。与ICAG相比，CTA诊断显著狭窄的敏感性为90%，特异性为94%，阳性预测值（PPV）为89%，阴性预测值（NPV）为95%。对于58个支架病变，敏感性、特异性、PPV和NPV分别为93%、96%、87%和98%。基于患者的分析中，CTA检测CAD的敏感性、特异性、PPV和NPV分别为98%、86%、98%和86%。由于心律不齐、钙化或心动过速，82个（8%）节段不可评估。
64-MSCT在未选择的患者群体中检测显著CAD具有很高的准确性，因此可被视为一种有价值的非侵入性技术。
