Department of Radiology, Zhejiang Hospital, Linying Road 12th of Hangzhou, Zhejiang Province, China.
Korean J Radiol. 2011 Jul-Aug;12(4):416-23. doi: 10.3348/kjr.2011.12.4.416. Epub 2011 Jul 22.
We wanted to evaluate the image quality and diagnostic value of 64-slice dual-source computed tomography (DSCT) coronary angiography in patients with atrial fibrillation (Afib).
The coronary arteries of 22 Afib patients seen on DSCT were classified into 15 segments and the imaging quality (excellent, good, moderate and poor) and significant stenoses (≥ 50%) were evaluated by two radiologists who were blinded to the conventional coronary angiography (CAG) results. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting important coronary artery stenosis were calculated. McNemar test was used to determine any significant difference between DSCT and CAG, and Cohen's Kappa statistics were calculated for the intermodality and interobserver agreement.
The mean heart rate was 89 ± 8.3 bpm (range: 80-118 bpm). A range from 250 msec to 300 msec within the RR interval was the optimal reconstruction interval for the patients with Afib. The respective overall sensitivity, specificity, PPV and NPV values were 74%, 97%, 81% and 96% for reader 1 and 72%, 98%, 85% and 96% for reader 2. No significant difference between DSCT and CAG was found for detecting a significant stenosis (reader 1, p = 1.0; reader 2, p = 0.727). Cohen's Kappa statistics demonstrated good intermodality and interobserver agreement.
64-slice DSCT coronary angiography provides good image quality in patients with atrial fibrillation without the need for controlling the heart rate. DSCT can be used for ruling out significant stenosis in patients with atrial fibrillation with its high NPV for detecting in important stenosis.
我们旨在评估双源 64 层螺旋 CT（DSCT）冠状动脉成像在心房颤动（Afib）患者中的图像质量和诊断价值。
对 22 例在 DSCT 上见到的 Afib 患者的冠状动脉进行 15 节段划分，并由两位放射科医生对成像质量（优秀、良好、中等和较差）和显著狭窄（≥50%）进行评估，两位放射科医生对常规冠状动脉造影（CAG）结果不知情。计算检测重要冠状动脉狭窄的灵敏度、特异性、阳性预测值（PPV）和阴性预测值（NPV）。采用 McNemar 检验比较 DSCT 和 CAG 之间是否存在显著差异，并用 Cohen's Kappa 统计检验两种模态之间以及观察者之间的一致性。
平均心率为 89 ± 8.3 bpm（范围：80-118 bpm）。Afib 患者 RR 间期内 250 msec 至 300 msec 的重建间隔为最佳重建间隔。两位观察者的整体灵敏度、特异性、PPV 和 NPV 值分别为 74%、97%、81%和 96%（观察者 1）和 72%、98%、85%和 96%（观察者 2）。DSCT 和 CAG 在检测显著狭窄方面无显著差异（观察者 1，p = 1.0；观察者 2，p = 0.727）。Cohen's Kappa 统计检验显示两种模态之间和观察者之间具有良好的一致性。
双源 64 层螺旋 CT 冠状动脉成像在无需控制心率的情况下为心房颤动患者提供了良好的图像质量。DSCT 可用于排除心房颤动患者的重要狭窄，因其检测显著狭窄的 NPV 较高。
