Department of Cardiology, Patras University Hospital, Rion 26500, Patras, Greece.
Int J Cardiol. 2012 Jul 26;158(3):370-5. doi: 10.1016/j.ijcard.2011.01.072. Epub 2011 Feb 26.
The diagnostic accuracy of flat panel digital detector (FPDD) cinefluoroscopy for coronary artery calcium (CAC) detection, compared to multiple detector computed tomography (MDCT), is not known.
CAC was assessed by FPDD cinefluoroscopy (graded as 0,1, 2 and 3) and calcium score (CACS) was determined by MDCT in 151 asymptomatic individuals of low to intermediate cardiovascular risk, 40-60 years old (mean age 53.1 ± 7.4, men 76.5%).
CAC was detected by MDCT and cinefluoroscopy in 79 (52.3%) and 69 (45.7%) of cases respectively. Agreement between MDCT and cinefluoroscopy was 77.5% (weighted kappa coefficient 0.75). Cinefluoroscopy was able to detect CAC in 50% of subjects with minimal CACS (<10). For CACS=0, area under the curve (AUC) was 0.89 (95% CI 0.83-0.93, p=0.0001) with sensitivity 82.3% and specificity 94.4%. For CACS=10, AUC was 0.91 (95% CI 0.86-0.95, p=0.0001) with sensitivity 91.8% and specificity 85.6%. For CACS=400, AUC was 0.97 (95% CI 0.94-0.99, p=0.0001) with sensitivity 100% and specificity 88.7%. The effective radiation dose was 1.8 ± 0.09 mSv for CT and 0.26 ± 0.13 mSv for cinefluoroscopy.
Cinefluoroscopy performed with 'state-of-the art' FPDD technology has an excellent diagnostic accuracy compared to the 'gold standard' MDCT for CAC detection in middle aged, low to intermediate cardiovascular risk, asymptomatic individuals, with the advantage of lower radiation exposure.
平板数字探测器（FPDD）电影透视在冠状动脉钙（CAC）检测方面的诊断准确性与多探测器计算机断层扫描（MDCT）相比尚不清楚。
对 151 名低至中度心血管风险、年龄 40-60 岁（平均年龄 53.1±7.4，男性 76.5%）的无症状个体进行 FPDD 电影透视（分级为 0、1、2 和 3）评估 CAC，并通过 MDCT 确定 CAC 评分（CACS）。
MDCT 和电影透视分别在 79 例（52.3%）和 69 例（45.7%）患者中检测到 CAC。MDCT 与电影透视的一致性为 77.5%（加权 κ 系数 0.75）。电影透视能够在最小 CACS（<10）的 50%患者中检测到 CAC。对于 CACS=0，曲线下面积（AUC）为 0.89（95%CI 0.83-0.93，p=0.0001），敏感性为 82.3%，特异性为 94.4%。对于 CACS=10，AUC 为 0.91（95%CI 0.86-0.95，p=0.0001），敏感性为 91.8%，特异性为 85.6%。对于 CACS=400，AUC 为 0.97（95%CI 0.94-0.99，p=0.0001），敏感性为 100%，特异性为 88.7%。有效辐射剂量为 CT 为 1.8±0.09 mSv，电影透视为 0.26±0.13 mSv。
使用“最先进”FPDD 技术的电影透视与 CAC 检测的“金标准”MDCT 相比，在中年、低至中度心血管风险、无症状个体中具有出色的诊断准确性，且具有较低的辐射暴露优势。
