Tsai I-Chen, Lee Tain, Lee Wen-Lieng, Tsao Chen-Rong, Tsai Wei-Lin, Chen Min-Chi, Ting Chih-Tai
Department of Radiology, Taichung Veterans General Hospital, Medical College of Chung Shang Medical University, Taiwan, Republic of China.
J Comput Assist Tomogr. 2007 Mar-Apr;31(2):258-64. doi: 10.1097/01.rct.0000237808.03499.e4.
Using catheter coronary angiography (CAG) as reference standard, we examined the agreement of 40-detector row computed tomography (MDCT) in triaging patients into the 2 controversial strategies of managing low-risk acute coronary syndrome (ACS).
Seventy-eight patients with low-risk ACS received both MDCT and CAG. Early invasive strategy was assigned for the patient if there was significant stenosis (> or =50% diameter stenosis) in any of the coronary artery segments with diameter larger than 1.5 mm. The results of MDCT were compared with the CAG for agreement.
The overall agreement of the early conservative/early invasive strategy assignment was 92.3%, with kappa value of 0.82 between MDCT and CAG. Only 1 patient needing early invasive strategy was missed by MDCT.
Forty-detector row computed tomography is reliable in triaging patients into the 2 strategies of managing low-risk ACS.
以导管冠状动脉造影（CAG）作为参考标准，我们研究了40排螺旋计算机断层扫描（MDCT）在将患者分诊至两种有争议的低危急性冠状动脉综合征（ACS）管理策略方面的一致性。
78例低危ACS患者同时接受了MDCT和CAG检查。如果直径大于1.5 mm的任何冠状动脉节段存在显著狭窄（直径狭窄≥50%），则为患者分配早期侵入性策略。将MDCT结果与CAG结果进行一致性比较。
早期保守/早期侵入性策略分配的总体一致性为92.3%，MDCT与CAG之间的kappa值为0.82。MDCT仅漏诊了1例需要早期侵入性策略的患者。
40排螺旋计算机断层扫描在将患者分诊至低危ACS的两种管理策略方面是可靠的。
