Department of radiology, Beijing Anzhen Hospital, Capital Medical University, No 2, Anzhen Road, Chaoyang District, 100029 Beijing, China.
Eur Radiol. 2011 May;21(5):936-43. doi: 10.1007/s00330-010-1987-0. Epub 2010 Dec 14.
To evaluate the feasibility, diagnostic accuracy, and radiation dose of CT coronary angiography (CTCA) in patients with atrial fibrillation (AF) using 320-detector CT.
Thirty-seven patients with persistent AF and suspected coronary artery disease (CAD) were enrolled. All patients underwent both 320-detector CTCA and conventional coronary angiography (CCA). CT image quality and the presence of significant (≥ 50%) stenosis were evaluated by two radiologists blinded to the results of CCA. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated using CCA as the reference standard. Differences in detection of coronary artery stenosis between 320-detector CTCA and CCA were evaluated with McNemar's test. Patient radiation dose was calculated by multiplying dose length product by conversion coefficient of 0.017.
In total 474 evaluated coronary segments, 459 (96.8%) segments were diagnostically evaluable. On per-segment analysis, sensitivity, specificity, PPV and NPV were 90.0% (18 of 20), 99.3% (436 of 439), 85.7% (18 of 21) and 99.5% (436 of 438). No significant difference was found between 320-detector CTCA and CCA on the detection of significant stenosis (P = 1.000). Effective doses of 320-detector CTCA was 13.0 ± 4.7 mSv.
320-detector CTCA is feasible and accurate in excluding CAD in patients with AF.
使用 320 排 CT 评估心房颤动（AF）患者 CT 冠状动脉成像（CTCA）的可行性、诊断准确性和辐射剂量。
纳入 37 例持续性 AF 并疑诊 CAD 的患者。所有患者均接受 320 排 CTCA 和常规冠状动脉造影（CCA）检查。由 2 名不知 CCA 结果的放射科医生评估 CT 图像质量和是否存在显著（≥50%）狭窄。以 CCA 为参考标准，计算敏感度、特异度、阳性预测值（PPV）和阴性预测值（NPV）。采用 McNemar 检验评估 320 排 CTCA 和 CCA 检测冠状动脉狭窄的差异。通过剂量长度乘积乘以 0.017 的转换系数计算患者的辐射剂量。
共评估了 474 个节段，459 个（96.8%）节段可诊断。节段分析显示，敏感度、特异度、PPV 和 NPV 分别为 90.0%（20 个中的 18 个）、99.3%（439 个中的 436 个）、85.7%（21 个中的 18 个）和 99.5%（438 个中的 436 个）。320 排 CTCA 与 CCA 检测显著狭窄无显著差异（P=1.000）。320 排 CTCA 的有效剂量为 13.0±4.7 mSv。
320 排 CTCA 可用于排除 AF 患者 CAD，具有可行性和准确性。
