Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University, GPO Box, U1987, Perth, Western Australia 6845, Australia.
J Geriatr Cardiol. 2012 Jun;9(2):115-22. doi: 10.3724/SP.J.1263.2012.01041.
To investigate the clinical applications of coronary CT angiography in patients with suspected coronary artery disease and identify factors that affect CT findings.
Medical records of patients suspected of coronary artery disease over a period of 12 months from a tertiary teaching hospital were retrospectively reviewed. Patient age, sex (male/female), duration of symptoms and abnormal rates of coronary CT angiography scans were analysed to investigate the relationship among these parameters. The patients by age were characterized into five groups: under 36 years, 36-45 years, 46-55 years, 56-65 years and more than 66 years, respectively; while the duration of symptoms was also classified into five groups: less than one week, one week to one month, one to three months, three to six months and more than six months.
Of the 880 patient records reviewed, 800 met the above study criteria. Five hundred and forty nine patients demonstrated abnormal CT findings (68.6%). There was no significant difference in the percentage of abnormal CT findings based on patient sex and the duration of symptoms (P = 0.14). The abnormal rates of coronary CT angiography, however, increased significantly with increasing age (P < 0.001); with patients over 65 years of age 2.5 times more likely to have an abnormal CT scan relative to a patient under 45 years. A significant difference was found between abnormal coronary CT angiography and the duration of symptoms (P = 0.012).
Our results indicate coronary CT angiography findings are significantly related to the patient age group and duration of symptoms. Clinical referral for coronary CT angiography of patients with suspected coronary artery disease needs to be justified with regard to the judicious use of this imaging modality.
探讨冠状动脉 CT 血管造影在疑似冠心病患者中的临床应用,并确定影响 CT 表现的因素。
回顾性分析 12 个月内在一家三级教学医院就诊的疑似冠心病患者的病历。分析患者年龄、性别(男/女)、症状持续时间和冠状动脉 CT 血管造影检查的异常率,以调查这些参数之间的关系。根据年龄将患者分为五组:<36 岁、36-45 岁、46-55 岁、56-65 岁和>66 岁;同时,根据症状持续时间将其分为五组:<1 周、1-1 个月、1-3 个月、3-6 个月和>6 个月。
在回顾的 880 份患者记录中,有 800 份符合上述研究标准。549 例患者 CT 检查结果异常(68.6%)。根据患者性别和症状持续时间,CT 检查异常率无显著差异(P=0.14)。然而,冠状动脉 CT 血管造影的异常率随年龄的增加而显著增加(P<0.001);与 45 岁以下患者相比,65 岁以上患者 CT 扫描异常的可能性增加了 2.5 倍。异常冠状动脉 CT 血管造影与症状持续时间之间存在显著差异(P=0.012)。
我们的结果表明,冠状动脉 CT 血管造影结果与患者年龄组和症状持续时间显著相关。对于疑似冠心病患者的冠状动脉 CT 血管造影临床转诊,需要合理使用这种影像学检查方法。