Li Ying, Yang Li, Wang Xin-Jiang, Zhao Xi-Hai, Zhao Lin-Fen
Radiology Department, General Hospital of PLA, Beijing 100853 , China.
Zhonghua Yi Xue Za Zhi. 2007 Dec 11;87(46):3243-6.
To evaluate the diagnostic accuracy of 64 multislice computed tomography (MSCT) coronary angiography on the coronary atherosclerosis.
Sixty one (52 male, 9 female, averaged 58 +/- 11 yrs ) patients underwent conventional coronary angiography and 64-MSCT angiography for suspected coronary artery disease within 5 to 20 days. Coronary artery image quality was scored from 1 to 4 (image quality score, 1: poor; 2: good -; 3: good +, and 4: excellent) on RCA, LM, LAD and LCX, respectively. The coronary artery stenosis were divided into two groups by over than 50% and less than 50% and diagnostic accuracy was analyzed. The coronary plaques were divided as calcified and noncalcified plaque according to its density. The stenosis result from calcified and noncalcified plaque were analyzed.
Mean score of image quality on RCA, LM, LAD and LCX was 3.57 +/- 0.18 with heart beats 50 - 104 bpm (mean 70 +/- 11 bpm). Compared with CAG, the sensitivity and specificity of 64-MSCT in evaluating stenosis are 94.45% and 96.15%, the false positive and false negative value are 3.85% and 4.55%. The sensitivity and specificity were 85.71% in evaluating stenosis result from noncalcified plaque and they were 83.33% and 31.57% result from calcified plaque.
64-MSCT is an accurate and feasible method in evaluating coronary artery stenosis compared to conventional coronary angiography. However the specificity was poor in evaluating calcified plaque.
评估64层螺旋计算机断层扫描(MSCT)冠状动脉造影对冠状动脉粥样硬化的诊断准确性。
61例(52例男性,9例女性,平均年龄58±11岁)疑似冠心病患者在5至20天内接受了传统冠状动脉造影和64层MSCT血管造影。分别对右冠状动脉(RCA)、左主干(LM)、左前降支(LAD)和左回旋支(LCX)的冠状动脉图像质量进行1至4分评分(图像质量评分,1:差;2:良-;3:良+;4:优)。将冠状动脉狭窄按超过50%和小于50%分为两组,并分析诊断准确性。根据冠状动脉斑块密度将其分为钙化斑块和非钙化斑块,并分析钙化斑块和非钙化斑块导致的狭窄情况。
RCA、LM、LAD和LCX图像质量的平均评分为3.57±0.18,心率为50 - 104次/分钟(平均70±11次/分钟)。与冠状动脉造影(CAG)相比,64层MSCT评估狭窄的敏感性和特异性分别为94.45%和96.15%,假阳性率和假阴性率分别为3.85%和4.55%。评估非钙化斑块导致的狭窄时,敏感性和特异性分别为85.71%;评估钙化斑块导致的狭窄时,敏感性和特异性分别为83.33%和31.57%。
与传统冠状动脉造影相比,64层MSCT是评估冠状动脉狭窄的一种准确且可行的方法。然而,在评估钙化斑块方面特异性较差。