West-German Heart Center Essen, Department of Cardiology, University of Duisburg-Essen, Germany.
Br J Radiol. 2012 Jul;85(1015):e300-6. doi: 10.1259/bjr/91904659. Epub 2011 Oct 18.
Cardiac CT allows the detection and quantification of coronary artery calcification (CAC). Electron-beam CT (EBCT) has been widely replaced by high-end CT generations in the assessment of CAC. The aim of this study was to compare the CAC scores derived from an EBCT with those from a dual-source CT (DSCT).
We retrospectively selected 92 patients (61 males; mean age, 60.7 ± 12 years) from our database, who underwent both EBCT and DSCT. CAC was assessed using the Agatston score by two independent readers (replicates: 1, 2; 3=mean of reading 1 and 2).
EBCT scores were on average slightly higher than DSCT scores (281 ± 569 vs 241 ± 502; p<0.05). In regression analysis R(2)-values vary from 0.956 (1) to 0.966 (3). We calculated a correction factor as EBCT=(DSCT+1)(1.026)-1. When stratifying into CAC categories (0, 1-99, 100-399, 400-999 and ≥1000), 79 (86%) were correctly classified. From those with positive CAC scores, 7 out of 61 cases (11%, κ=0.81) were classified in different categories. Using the corrected DSCT CAC score, linear regression analysis for the comparison to the EBCT results were r=0.971 (p<0.001), with a mean difference of 6.4 ± 147.8. Five subjects (5.4%) were still classified in different categories (κ=0.84).
CAC obtained from DSCT is highly correlated with the EBCT measures. Using the calculated correction factor, agreement only marginally improved the clinical interpretation of results. Overall, for clinical purposes, face value use of DSCT-derived values appears as useful as EBCT for CAC scoring.
心脏 CT 可检测和量化冠状动脉钙化（CAC）。电子束 CT（EBCT）在 CAC 评估中已被高端 CT 技术广泛取代。本研究旨在比较 EBCT 和双源 CT（DSCT）得出的 CAC 评分。
我们从数据库中回顾性选择了 92 名患者（61 名男性；平均年龄 60.7 ± 12 岁），这些患者均同时接受了 EBCT 和 DSCT 检查。CAC 采用 Agatston 评分进行评估，由两位独立的读者（重复 1、2；3=1 和 2 的平均值）进行。
EBCT 评分平均略高于 DSCT 评分（281 ± 569 比 241 ± 502；p<0.05）。在回归分析中，R²值从 0.956（1）到 0.966（3）不等。我们计算了一个校正因子，即 EBCT=(DSCT+1)(1.026)-1。当按 CAC 类别（0、1-99、100-399、400-999 和≥1000）分层时，79（86%）被正确分类。在 CAC 评分阳性的患者中，61 例中有 7 例（11%，κ=0.81）被分为不同类别。使用校正后的 DSCT CAC 评分，与 EBCT 结果的线性回归分析 r=0.971（p<0.001），平均差异为 6.4 ± 147.8。有 5 名受试者（5.4%）仍被分为不同类别（κ=0.84）。
DSCT 得出的 CAC 与 EBCT 测量结果高度相关。使用计算出的校正因子，仅略微改善了结果的临床解释。总的来说，对于临床目的，DSCT 衍生值的直接使用与 EBCT 相比，对 CAC 评分同样有用。
