Henneman M M, Schuijf J D, Jukema J W, Lamb H J, de Roos A, Dibbets P, Stokkel M P, van der Wall E E, Bax J J
Department of Cardiology, Leiden University Medical Center, The Netherlands.
Heart. 2006 Dec;92(12):1779-83. doi: 10.1136/hrt.2006.087874. Epub 2006 Jun 1.
To evaluate a comprehensive multislice computed tomography (MSCT) protocol in patients with previous infarction, including assessment of coronary artery stenoses, left ventricular (LV) function and perfusion.
16-slice MSCT was performed in 21 patients with previous infarction; from the MSCT data, coronary artery stenoses, (regional and global) LV function and perfusion were assessed. Invasive coronary angiography and gated single-photon emission computed tomography (SPECT) served as the reference standards for coronary artery stenoses and LV function/perfusion, respectively.
236 of 241 (98%) coronary artery segments were interpretable on MSCT. The sensitivity and specificity for detection of stenoses were 91% and 97%. Pearson's correlation showed excellent agreement for assessment of LV ejection fraction between MSCT and SPECT (49 (13)% v 53 (12)%, respectively, r = 0.85). Agreement for assessment of regional wall motion was excellent (92%, kappa = 0.77). In 68 of 73 (93%) segments, MSCT correctly identified a perfusion defect as compared with SPECT, whereas the absence of perfusion defects was correctly detected in 277 of 284 (98%) segments.
MSCT permits accurate, non-invasive assessment of coronary artery stenoses, LV function and perfusion in patients with previous infarction. All parameters can be assessed from a single dataset.
评估一种针对既往有心肌梗死患者的综合多层螺旋计算机断层扫描（MSCT）方案，包括评估冠状动脉狭窄、左心室（LV）功能和灌注情况。
对21例既往有心肌梗死的患者进行了16层MSCT检查；从MSCT数据中评估冠状动脉狭窄、（局部和整体）LV功能及灌注情况。有创冠状动脉造影和门控单光子发射计算机断层扫描（SPECT）分别作为冠状动脉狭窄和LV功能/灌注的参考标准。
241个冠状动脉节段中的236个（98%）在MSCT上可解读。检测狭窄的敏感性和特异性分别为91%和97%。Pearson相关性分析显示，MSCT与SPECT评估LV射血分数的一致性良好（分别为49（13）%和53（12）%，r = 0.85）。评估局部室壁运动的一致性良好（92%，kappa = 0.77）。与SPECT相比，73个节段中的68个（93%）MSCT正确识别出灌注缺损，而284个节段中的277个（98%）正确检测到无灌注缺损。
MSCT能够对既往有心肌梗死的患者进行准确的冠状动脉狭窄、LV功能和灌注的无创评估。所有参数均可从单一数据集中进行评估。
