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320 排多层螺旋 CT 冠状动脉造影对冠状动脉疾病的无创评估的诊断准确性。

Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography in the non-invasive evaluation of significant coronary artery disease.

机构信息

Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.

出版信息

Eur Heart J. 2010 Aug;31(15):1908-15. doi: 10.1093/eurheartj/ehp571. Epub 2010 Jan 4.

Abstract

AIMS

Multidetector computed tomography coronary angiography (CTA) has emerged as a feasible imaging modality for non-invasive assessment of coronary artery disease (CAD). Recently, 320-row CTA systems were introduced, with 16 cm anatomical coverage, allowing image acquisition of the entire heart within a single heart beat. The aim of the present study was to assess the diagnostic accuracy of 320-row CTA in patients with known or suspected CAD.

METHODS AND RESULTS

A total of 64 patients (34 male, mean age 61 +/- 16 years) underwent CTA and invasive coronary angiography. All CTA scans were evaluated for the presence of obstructive coronary stenosis by a blinded expert, and results were compared with quantitative coronary angiography. Four patients were excluded from initial analysis due to non-diagnostic image quality. Sensitivity, specificity, and positive and negative predictive values to detect > or =50% luminal narrowing on a patient basis were 100, 88, 92, and 100%, respectively. Moreover, sensitivity, specificity, and positive and negative predictive values to detect > or =70% luminal narrowing on a patient basis were 94, 95, 88, and 98%, respectively. With inclusion of non-diagnostic imaging studies, sensitivity, specificity, and positive and negative predictive values to detect > or =50% luminal narrowing on a patient basis were 100, 81, 88, and 100%, respectively.

CONCLUSION

The current study shows that 320-row CTA allows accurate non-invasive assessment of significant CAD.

摘要

目的

多排螺旋 CT 冠状动脉血管造影(CTA)已成为一种可行的无创性评估冠状动脉疾病(CAD)的成像方式。最近,推出了 320 排 CTA 系统,具有 16cm 的解剖覆盖范围,可在单次心跳内完成整个心脏的图像采集。本研究旨在评估 320 排 CTA 在已知或疑似 CAD 患者中的诊断准确性。

方法和结果

共有 64 名患者(34 名男性,平均年龄 61±16 岁)接受了 CTA 和有创冠状动脉造影。所有 CTA 扫描均由一位盲法专家评估是否存在阻塞性冠状动脉狭窄,并将结果与定量冠状动脉造影进行比较。由于初始分析中存在非诊断性图像质量,有 4 名患者被排除在外。以患者为基础,检测>或=50%管腔狭窄的敏感性、特异性、阳性预测值和阴性预测值分别为 100%、88%、92%和 100%。此外,以患者为基础,检测>或=70%管腔狭窄的敏感性、特异性、阳性预测值和阴性预测值分别为 94%、95%、88%和 98%。包括非诊断性影像学研究在内,以患者为基础,检测>或=50%管腔狭窄的敏感性、特异性、阳性预测值和阴性预测值分别为 100%、81%、88%和 100%。

结论

本研究表明,320 排 CTA 可准确进行无创性评估严重 CAD。

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