Timins M E, Pinsk R, Sider L, Bear G
Department of Diagnostic Radiology, Medical College of Wisconsin, Milwaukee.
J Thorac Imaging. 1991 Dec;7(1):79-82. doi: 10.1097/00005382-199112000-00010.
We evaluated the coronary arteries on computed tomography (CT) scans of the chest and on coronary angiograms of 27 patients who underwent both studies. We related the presence or absence of coronary artery calcification on CT to percentage stenosis on angiogram. For the left anterior descending artery (LAD), the likelihood of calcification rose proportionately with degree of stenosis; this was less true for the circumflex, and not true for the right coronary artery (RCA). The sensitivity of CT in detecting coronary artery calcification in patients with angiographic criteria of significant coronary artery disease (CAD) was 78% for the LAD, 63% for the circumflex, and 16% for the RCA. Specificities were 78%, 80%, and 100%, and positive predictive values were 88%, 83%, and 100%. The high positive predictive values suggest that coronary artery calcification diagnosed by chest CT has a high correlation with clinically significant CAD. Therefore, when we detect such calcification in a patient without documented heart disease, we suggest that a cardiac workup is indicated.
我们对27例同时接受胸部计算机断层扫描（CT）和冠状动脉造影的患者的冠状动脉进行了评估。我们将CT上冠状动脉钙化的有无与血管造影上的狭窄百分比相关联。对于左前降支（LAD），钙化的可能性随狭窄程度成比例增加；对于回旋支，情况不太如此，而对于右冠状动脉（RCA）则并非如此。在具有显著冠状动脉疾病（CAD）血管造影标准的患者中，CT检测LAD冠状动脉钙化的敏感性为78%，回旋支为63%，RCA为16%。特异性分别为78%、80%和100%，阳性预测值分别为88%、83%和100%。高阳性预测值表明，胸部CT诊断的冠状动脉钙化与具有临床意义的CAD高度相关。因此，当我们在无心脏病记录的患者中检测到这种钙化时，我们建议进行心脏检查。
