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[采用前瞻性心电图触发的冠状动脉CT血管造影:高诊断准确性与低辐射剂量]

[Coronary CT angiography using prospective ECG triggering: high diagnostic accuracy with low radiation dose].

作者信息

Arnoldi E, Ramos-Duran I, Abro J A, Zwerner P L, Nikolaou K, Reiser M F, Costello P, Schoepf U J

机构信息

Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, Charleston, USA.

出版信息

Radiologe. 2010 Jun;50(6):500-6. doi: 10.1007/s00117-010-1985-x.

Abstract

BACKGROUND

The purpose of this study was to evaluate the diagnostic performance of coronary CT angiography (coronary CTA) using prospective ECG triggering (PT) for the detection of significant coronary artery stenosis compared to invasive coronary angiography (ICA).

METHODS

A total of 20 patients underwent coronary CTA with PT using a 128-slice CT scanner (Definition AS+, Siemens) and ICA. All coronary CTA studies were evaluated for significant coronary artery stenoses (>or=50% luminal narrowing) by 2 observers in consensus using the AHA-15-segment model. Findings in CTA were compared to those in ICA.

RESULTS

Coronary CTA using PT had 88% sensitivity in comparison to 100% with ICA, 95% to 88% specificity, 80% to 92% positive predictive value and 97% to 100% negative predictive value for diagnosing significant coronary artery stenosis on per segment per patient analysis, respectively. Mean effective radiation dose-equivalent of CTA was 2.6+/-1 mSv.

CONCLUSION

Coronary CTA using PT enables non-invasive diagnosis of significant coronary artery stenosis with high diagnostic accuracy in comparison to ICA and is associated with comparably low radiation exposure.

摘要

背景

本研究的目的是评估前瞻性心电图触发(PT)的冠状动脉CT血管造影(冠状动脉CTA)与有创冠状动脉造影(ICA)相比,在检测显著冠状动脉狭窄方面的诊断性能。

方法

共有20例患者接受了使用128层CT扫描仪(Definition AS+,西门子)进行的PT冠状动脉CTA和ICA检查。由2名观察者使用美国心脏协会(AHA)15段模型,对所有冠状动脉CTA研究进行一致性评估,以确定是否存在显著冠状动脉狭窄(管腔狭窄≥50%)。将CTA的结果与ICA的结果进行比较。

结果

在每位患者每段分析中,使用PT的冠状动脉CTA诊断显著冠状动脉狭窄的敏感性为88%,而ICA为100%;特异性分别为95%和88%;阳性预测值分别为80%和92%;阴性预测值分别为97%和100%。CTA的平均有效辐射剂量当量为2.6±1 mSv。

结论

与ICA相比,使用PT的冠状动脉CTA能够以高诊断准确性对显著冠状动脉狭窄进行无创诊断,且辐射暴露相对较低。

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